Introduction: A 58-year-old Hispanic woman presented with a 2-day history of a pruritic rash that had started on her hands before spreading to her abdomen, chest, upper extremities, and lower extremities. Her history was significant for chronic hepatitis C (HCV), genotype 1, but no prior history of vasculitis. She had been started on ribavirin, peginterferon alfa 2-a, and sofosbuvir 6 weeks prior to admission, with an undetectable HCV RNA PCR after 4 weeks. However, treatment had been stopped 2 weeks prior to admission due to neutropenia (ANC 400 cells/mL). Her temperature on admission was 101.7 °F. On physical exam, she had edematous pink plaques on the dorsal hands, elbows, and proximal bilateral lower extremities. There were purpuric papules and plaques on the bilateral midlower thighs, shins, ankles, and feet. White blood cell count was 2,4000 cells/μL with normal differential, hemoglobin 11.9 mg/dL, platelets 119000 cells/μL, and creatinine 0.7 mg/dL. Urinalysis did not show proteinuria. Liver function and iron studies were unremarkable. ANA, ANCA, CRP, ESR, HIV, anticardiolipin antibodies, beta-2-glycoprotein, and lupus anticoagulant were normal. Cryoglobulins were positive, with low complement levels, mildly elevated rheumatoid factor, and undetectable HCV viral load. Punch biopsy showed leukocytoclastic vasculitis. She was started on a steroid taper, and at 2-week follow-up, her rash had resolved completely. Here, we present a case of a patient with cryoglobulinemic vasculitis on co-therapy with interferon (IFN) and sofosbuvir. Cryoglobulins may be seen in 40-56% of patients with HCV infection, with vasculitis only seen in <5% of patients with cryoglobulinemia. In these cases, vasculitis usually improves with treatment of HCV. However, there have been reports of cryoglobulinemic vasculitis initially appearing after initiation of treatment with interferon, with unknown rates of occurrence in the setting of co-therapy with sofosbuvir. Treatment in these cases usually consists of corticosteroids with or without immunosuppression using cyclophosphamide. In our patient’s case, administration of prednisone led to complete resolution of vasculitis, with no residual purpura, neuropathy, or renal insufficiency. Viral load remained undetectable at all times. This shows the importance of close monitoring of patients while on treatment with interferon and sofosbuvir, regardless of the viral load.