After infection of a cell, the positive-strand RNA genome of Hepatitis C Virus (HCV) directly serves as the template for translation in the cytosol. By the use of an internal ribosome entry site (IRES) element in the 5'-untranslated region (5'-UTR) of the viral RNA, the HCV RNA bypasses the need for nuclear processing events like capping and directly recruits the translation apparatus to the viral RNA to start translation of the viral proteins. In this review, I discuss the structure and function of the HCV IRES, focusing on (1) the recruitment of the cellular translation machinery to the IRES, including canonical and noncanonical translation initiation factors, (2) noncanonical RNA-binding proteins that modulate IRES activity, and (3) microRNAs that have an influence on the efficiency of HCV RNA translation.