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We measured hepatitis C virus (HCV) adherence via electronic blister packs for 145 people who inject drugs treated on-site in a methadone program. The overall sustained virologic response (SVR) rate was 96% (95% CI, 91%-98%), and overall daily adherence was 78% (95% CI, 76%-81%). Participants who achieved at least 50% adherence had an overall SVR rate of 99%, with each 5% adherence interval 50% achieving at least 90% adherence. Suboptimal adherence may still lead to cure in the direct-acting antiviral era. People who use drugs (PWUD)