Introduction: Haematological manifestations are among the most common extrahepatic manifestations of hepatitis C virus infection with an established association, such as mixed cryoglobulinemia and lymphoproliferative disorders. However, the relationship between HCV infection and myelogenous disorders is still controversial.
 
Case presentation: We report a case of a 40-year-old man, an active smoker with a previous history of alcoholism and drug abuse (abstinence for 6 years), presenting a chronic hepatitis C infection with liver cirrhosis and concomitant pancytopenia due to myelodysplastic neoplasm with low bone marrow blasts (according to 2023 WHO classification), absent genetic mutations and no of history of exposure to occupational risk factors. He was treated with direct-acting antiviral therapy (Sofosbuvir + Daclatasvir for 24 weeks) and blood transfusions, and a follow-up period of 24 months obtained a sustained virological response and resolution of the hematological manifestations.
Conclusion: Several authors reported a concomitant myelodysplastic neoplasm in chronic hepatitis C infection. However, the causality effect relation and its risk factors are yet to be established. Nevertheless, antiviral treatment might resolve the myelodysplastic neoplasm, as reported in our case.