Background. Sexual transmission of hepatitis C virus (HCV) is still debated. The aim of this study was to evaluate the role of sexual transmission of HCV among hemodialysis patients and their partners. Methods. We investigated intrafamilial spread of HCV between 53 married hemodialysis patients reporting stable monogamous sexual activity and their partners, using an epidemiological questionnaire on risk factors for HCV, a third-generation ELISA to determine anti-HCV status, and a PCR test to detect HCV RNA. An additional 84 single patients with no reported regular sexual activity were considered the control group. Results. Of the 53 married patients, 16 (30.2%) were anti-HCV positive (all HCV-RNA positive), and 37 were anti-HCV negative (all HCV-RNA negative). There were no statistically significant differences between anti-HCV-positive and anti-HCV-negative married patients in mean age, gender, blood transfusion, and mean time on dialysis. None of the husbands or wives of the 16 anti-HCV-positive hemodialysis patients had antibodies to HCV. Similarly, of the 37 partners of anti-HCV-negative patients, none was anti-HCV positive. Conclusion. Our data suggest a very low risk of heterosexual transmission of HCV between hemodialysis patients and their partners.