One challenge to achieving HCV elimination through therapeutic intervention is reinfection. There is concern that HCV reinfection may compromise HCV treatment outcomes in populations with ongoing risk behaviors, with the risk of reinfection cited as a reason for not offering treatment to PWID. This review summarizes the literature regarding reinfection after successful HCV treatment among PWID, discusses strategies to reduce HCV infection and reinfection, and highlights the potential individual- and population-level impact of DAA treatmentscale up on HCV elimination.