The benefits of direct-acting antiviral (DAA) therapy for hepatitis C in patients with hepatocellular carcinoma (HCC) have been debated. In a retrospective cohort study of 797 patients with HCV-related HCC with a complete response to HCC treatment (383 patients received DAAs, 414 patients did not), DAA therapy was associated with a significant reduction in the risk of death (HR 0.54; 95% CI 0.33–0.90). Furthermore, this association differed by whether or not patients had achieved a sustained virologic response (SVR) to DAA therapy, with risk of death reduced in those who had achieved SVR (HR 0.29; 95% CI 0.18–0.47), but not in those who did not achieve SVR (HR 1.13; 95% CI 0.55–2.33).