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Historic models of hepatitis C treatment have not been suitably adapted for people who inject drugs (PWIDs). With the availability of highly effective direct acting antivirals (DAAs) and the possibility to eliminate hepatitis C as a public health threat, there is an urgency to improve treatment provision and uptake among PWID. This commentary explores the role of needle and syringe programs (NSPs) in providing hepatitis C treatment to PWID through an exploration of Positively Hep, a peer-referral, incentive-based project in Sydney, Australia. Positively Hep uses peer-networks to engage clients and introduce them to hepatitis C education, screening, and treatment. Within the first 26 months of operation, Positively Hep has provided education about hepatitis C and DAA treatments to 326 individuals, and has tested 145 people, 44% (n = 64) of whom have tested positive. Of these individuals, 21 (33%) have begun treatment, and 18 (28%) have successfully completed treatment. Positively Hep highlights the benefits of having trustworthy, timely, convenient, and client-friendly services to engage PWID and support them throughout hepatitis C treatment. This commentary is intended to prompt discussion about incorporating hepatitis C treatment into NSP service delivery, which could increase treatment uptake among PWID and support progress toward elimination targets. [ABSTRACT FROM AUTHOR]