Chronic hepatitis C in the setting of rheumatoid arthritis may be an obstacle to optimal management because of potential hepatotoxicity and adverse effects from immune suppression in these patients with a chronic infection. There are no reports in the literature discussing the use of abatacept, a T-cell costimulatory blocker, in patients with chronic hepatitis C. This article is the first report to describe the use of abatacept in 2 patients with rheumatoid arthritis and concomitant hepatitis C with favorable outcome.