Background/Aims: Hepatitis C is a major cause of hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) has been widely performed as a curative treatment for small HCC. The knowledge of prognostic factors in hepatitis C patients with small HCC after RFA is therefore important. Methodology: One hundred consecutive hepatitis C patients with a single HCC 3cm or less treated with RFA were enrolled. The cumulative recurrence and survival rates were calculated using Kaplan-Meier analysis. Prognostic factors were investigated using the Cox proportional hazard model. Results: Five-year local and distant intrahepatic recurrence rates were 10.4% and 70.9%, respectively. Five-year overall survival and recurrence-free survival rates were 60.3% and 15.9%, respectively. Multivariate analysis revealed that an age of 75 years or more [relative hazard (RH) 1.61, p=0.019] and a serum albumin level less than 3.5g/dL (RH 1.61, p=0.016) were significant factors for decreased overall survival. Furthermore, a serum albumin level less than 3.5g/dL (RH 1.50, p=0.003) was the only significant factor for decreased recurrence-free survival. Conclusions: This study suggests that host-related factors (age and serum albumin level) are important in predicting survival in hepatitis C patients with a single small HCC after RFA.