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Background Hepatitis C remains a significant contributor to liverrelated morbidity and mortality across Asia, yet progress in prevention and treatment continues to vary widely. Persistent gaps in case detection, access to curative antiviral therapy, and harmreduction services contribute to substantial differences in transmission dynamics and disease outcomes across subregions. This study aimed to quantify the contemporary total burden attributable to Hepatitis C across Asia in 2023.Methods Burden estimates were derived from the Global Burden of Disease 2023, encompassing incidence, mortality, and disabilityadjusted life years (DALYs). Analyses incorporated sexstratified, agespecific, and countrylevel burdens across Asia. Temporal trends were quantified as percentage changes from 1990 to 2023, allowing comparison of longterm patterns.Results In 2023, Hepatitis C incidence ranged from 0.03 million cases (95% UI: 0.02–0.03) in Oceania to 2.31 million (95% UI: 1.97–2.71) in East Asia. Males had consistently higher mortality and DALY counts across all regions, whereas the incident count was higher in females in every region except East Asia. Agespecific incidencerate peaks were observed at 20–49 years in Central Asia, 50–54 years in Highincome Asia Pacific, and 35–44 years in Southeast Asia and Oceania. East Asia had the lowest agestandardized death rate (ASDR) and agestandardized DALYs (ASDALYs) in 2023. In contrast, Central Asia and Southeast Asia recorded the highest values for agestandardized incidence (ASIR), ASDR, and ASDALYs. Highincome Asia Pacific had the lowest ASIR. By country, China ranked first for incident cases, followed by India and Indonesia; for deaths and DALYs, India and Indonesia ranked top two, with China third. From 1990 to 2023, incident cases increased in all regions, with the largest rise in Oceania (+140.0%); no significant change in incidence was detected in East Asia or Highincome Asia Pacific. Mortality rose in all regions except East Asia. DALYs increased in Oceania, Central Asia, and Southeast Asia, and declined in Highincome Asia Pacific.Conclusions HepC imposes a substantial yet uneven burden across Asia, characterized by femalepredominant incidence in most regions but malepredominant mortality and DALYs, distinct agepeak profiles, and pronounced regional contrasts in agestandardized rates. Rising incident cases in multiple subregions—particularly Oceania—and the concentration of severe outcomes in Central and Southeast Asia highlight the need for regionspecific strategies.