Background: Hepatitis C virus (HCV) infection is a worldwide disease. HCV-related arthritis is one of the extrahepatic manifestations of the disease. The treatment of chronic HCV has been revolutionized with the introduction of oral direct-acting antiviral (DAA) drugs. Objective: To determine the outcomes of treatment by the combination of sofosbuvir-daclatasvir with or without ribavirin in patients with HCV-related arthritis. Methods: A single-center, observational, prospective study, which enrolled a total of forty Egyptian patients with concurrent HCV viremia and HCV-related arthritis recruited as follows: 20 patients who were already assigned to receive the combination of sofosbuvir-daclatasvir (DCV) with or without ribavirin regimens (group I) and 20 patients from the waiting list of the same therapy. Outcomes of therapy were evaluated by the following: viral load, tender joints count, swollen joints count, visual analogue scale of pain, morning stiffness duration, rheumatoid factor titer, erythrocyte sedimentation rate and musculoskeletal ultrasound scores. All patients were evaluated prior to therapy then, 12 weeks after it. Results: Post-therapy, all group I patients had sustained viral response. Significant improvement of the outcome parameters was found 12 weeks post-treatment in group I compared to baseline and group II. Complete and partial remission of articular symptoms in group I patients was observed in 80% and 5% respectively, while 85% of patients in group II showed no remission. Few mild side effects were encountered with therapy. Conclusion: The combination of sofosbuvir-daclatasvir with or without ribavirin is an effective and safe therapy for eradication of HCV infection and amelioration of HCV-related arthritis.