Objective To explore the influencing factors for chronic hepatitis C( CHC) with thyroid dysfunction( TD) in untreated Chinese patients and provide evidence for clinical individualized treatment. Methods One thousand and twelve untreated CHC patients were collected nationwide in China. Thyroid function and associated influencing factors( region,age,gender,and hepatitis C virus( HCV) RNA replication level) in the patients were investigated. The relationships between the influencing factors and CHC with TD were analyzed. Between- group comparison of categorical data was performed by χ2test and Fisher' s exact test. Results There were geographical differences between different types of CHC with TD. Across different regions,the incidence of TD was highest in north and northwest China,i. e.,28. 3%and 26. 5%,respectively. Subclinical hypothyroidism was the most common type of TD,accounting for 58. 8% of the total TD cases. Middle- aged patients were most common among the cases of CHC with TD( 44. 0%),who had a significantly higher incidence of hypothyroidism than other age groups( χ2= 10. 10、6. 17,P = 0. 001、0. 013). Females with CHC had a significantly higher incidence of TD than male patients( 58. 9% vs. 41. 1%,χ2= 13. 1,P = 0. 00). Although a high HCV RNA replication level was most common in Chinese patients with CHC,this factor had little influence on TD. Conclusion In China,CHC with TD is influenced by geographic distribution,gender,and age,but less associated with HCV RNA replication level.