Objective To retrospectively observe and analyze perioperative and postoperative indicators and complications of patients with hepatitis C underwent total joint arthroplasty. Methods From 2010 to 2015, 23 cases of hepatitis C patients with hip replacement surgery in our hospital were slected as the hepatitis C group, and 35 patients without hepatitis C infection who received hip replacement surgery randomly selected as the control group. The baseline data of two groups, such as the age, gender, the perioperative data, post-operational complications (drugs-induced and operation-induced) were observed and collected. The results and the differences between the two groups were analyzed by SPSS 19.0 software. Results The two groups whad no difference of gender, age, Deyo score and preoperative Harris score. Among the HCV patients, 11.36% had the acute infection, 47.54% patients were chronic infection and others were in latent infection. The operation time of the HCV group was significantly longer than the control group (124.62 ± 37.53) min vs (117.67 ± 41.07) min, P < 0.01. The bleeding amount of HCV group was significantly more than control group (619.7 ± 116.8) ml vs (453.20 ± 62.90) ml, P < 0.01. The first ambulation time and total in-hospital duration of the HCV group were both significantly longer than the control group. Harris score of  the HCV group after operation was significantly lower than the control group (57.69 ± 9.55) vs (32.21 ± 4.97), P < 0.01. The incidence of complications after joint replacement in patients with hepatitis C was significantly higher than the control group. Conclusions Risk of total hip arthroplasty for Hepatitis C patients is increased, and complications incidence  associated with the surgery is increased. The related risks shall be informed to patients, intraoperative operation should be more careful, and postoperative close observation should be given to prevent complications.