Hepatitis C virus (HCV) infects 71 million individuals (around 1% of global population) and results in 399 thousands of death cases per year due to complications of infection. Between 55% and 85% of HCV infected individuals develop chronic hepatitis C (CHC), which can lead to hepatic (liver cirrhosis and hepatocellular carcinoma) and extrahepatic manifestations (EHM). Extrahepatic manifestations can sometimes be the first and the only sign of CHC and they occur in up to 74% of CHC. Extrahepatic manifestations can be classified according to the affected organ system, pathophysiological mechanism or according to the strength of evidence by which they are linked with CHC. Antiviral treatment of HCV represents the etiologic treatment of EHM, which is today especially interesting because of the occurrence of new and efficient antiviral drugs, DAAs. Best described EHM are the group of lymphoproliferative disease, which include essential mixed cryoglobulinaemia, B-cell non-Hodgkin lymphoma and monoclonal gammopathy. Chronic hepatitis C can affect the skin, resulting in disease such as porphyria cutanea tarda and lichen planus, and lead to chronic progressive and life-threatening renal disease, most frequently type 1 membranoproliferative glomerulonephritis and membranous nephropathy. It has been recognised that CHC is an important risk factor of cardiovascular disease such as atherosclerosis, coronary artery disease, myocardial infarction, stroke and peripheral artery disease. Chronic hepatitis C can also affect the endocrine system and metabolism, resulting in development of insulin resistance, type 2 diabetes, steatosis and thyroid disease, which are important because they increase the cardiovascular risk. A link has also been established between CHC and neuropsychiatric disease such as fatigue, depression, sleep disturbance and neurocognitive impairment. Chronic hepatitis C can also present with other autoimmune disease such as Sjögren syndrome and production of autoantibodies, and rarely with musculoskeletal, ophthalmological and pulmonary manifestations. This paper describes the pathophysiology, clinical presentation, diagnostics and treatment of the most common EHM.