Objectives To assess knowledge, attitudes and practices towards hepatitis C of primary care physicians (PCPs) working in a Southern Italian area. Methods A questionnaire exploring the basic knowledge on risk factors and the management of hepatitis C virus infection was administered in two occasions to a sample of PCPs before and 2 months later the presentation of the EASL guidelines on the management of HCV infection. Results At the first survey, drug addiction, transfusion in 1982 and sexual contact with multiple partners were listed as the most common risk factors for acquiring HCV infection. As many as 27% of PCPs believed that blood transfusion after 1994 was still an important risk factor for this infection. Only 38% of PCPs would refer HCV positive subject with abnormal ALT levels to a gastroenterologist. Some points showed a definite improvement when first and second survey were compared: the more frequent use of qualitative instead of quantitative HCV-RNA testing for diagnostic purpose and the selection of IFN plus ribavirin as the regimen of choice for active disease. Conclusions The general practice management of hepatitis C may be improved using educational activities involving directly and interactively PCPs.