Although the WHO strategy aims to eliminate the hepatitis C virus (HCV) as a public health threat by 2030, national strategies are variable worldwide. This study aimed to assess the establishment of different policies and strategies to eliminate HCV in the Americas. We conducted a 23-item survey about HCV-related policies and strategies among gastroenterologists and hepatologists in the Americas. The survey was carried out electronically (2022–2023). Data were compared with governmental institutions, regulatory agencies, scientific societies, and scientific publications. We estimated an index obtained from a regression scoring method through exploratory analysis, and row values were normalized from 0 to 100. We obtained 52 responses from 19 countries. The median HCV-related policies index was 51.4 IQR:27.3–70.1. The lower establishment of HCV-related policies was observed in Ecuador (0.0), Honduras (6.6), and Costa Rica (9.8), while the highest performance was observed in Argentina (94.1), Colombia (94.7), and Canada (100)(Figure 1A). Fifteen (78.9%) countries have adopted a national strategic plan to eliminate HCV. Three (15.8%) countries have universal screening for HCV infection (Figure 1B). After a positive HCV serological test, 10 (52.6%) countries perform reflex testing to confirm HCV diagnosis using the same sample. However, only 7 (36.8%) countries have an alert system for the requesting physician. Twelve (63.2%) countries have a direct referral system for specialized care of HCV-positive cases. Universal access to direct-acting antivirals (DAAs) exists in 15 (78.9%) countries. Universal access to DAAs was not widely available in Cuba, Ecuador, Venezuela, and the United States. Seven (36.8%) countries have generic DAAs available. Only 3 (15.8%) countries performed a retrospective search for HCV-positive cases that could have been lost to follow-up. Although most countries have adopted a national strategic plan to eliminate HCV, there are several issues and barriers to elimination in the Americas.