OBJECTIVE: To study the epidemiology and trends of HCV infection among women aged 15-49, this research aims to inform public health strategies and reduce its global impact by addressing maternal and child transmission risks. DESIGN: This research analyzed GBD data (1990-2021) on HCV in women aged 15-49, examining ASIR, ASPR, ASMR, and ASDR trends by region and age. APC and Bayesian models predicted future trajectories to guide public health policies. RESULTS: From 1990 to 2021, the global burden of hepatitis C virus (HCV) among women aged 15 - 49 witnessed a downward trend. The incidence rate (5.46 per 100,000) and mortality rate (0.068 per 100,000) of acute HCV were notably lower than those of chronic HCV, which stood at an incidence rate of 29.92 per 100,000 and a mortality rate of 1.42 per 100,000. In 2021, regions with a low Sociodemographic Index (SDI) endured the heaviest burden. Oceania, Central Asia, Eastern Europe, and several other regions experienced an upward trend in acute HCV cases; meanwhile, the number of chronic HCV cases increased in most regions, with the exception of Australasia. Pakistan had the highest HCV burden globally. Projections indicate that over the next decade, both the incidence and mortality rates of HCV will continue to decline, yet the total number of cases is expected to rise. CONCLUSION: This study reveals the complex epidemiological landscape of acute and chronic hepatitis C in women of reproductive age globally. Despite the anticipated decline in standardized incidence and mortality rates of acute and chronic hepatitis C among women of reproductive age worldwide in the coming decade, the actual number of cases continues to increase annually. This underscores the substantial challenges faced by the World Health Organization's goal of eliminating HCV infection by 2030.