Between April and September of 2009 we evaluated the accuracy of the OraQuick HCV rapid antibody test and assessed its feasibility for use by community-based organizations (CBOs) serving populations at high risk for HCV in New York City. We compared the results of screening by OraQuick (oral swab) and enzyme immunoassay (EIA; blood draw). We performed ribonucleic acid polymerase chain reaction testing for discordant results. We also assessed research staff perceptions through a survey and focus group. Overall, 97.5% of OraQuick and EIA results matched. Testing of discordant samples indicated that the rapid test was more likely than the EIA to provide a correct diagnosis. Research staff preferred the rapid test and identified challenges that would be overcome with its use. CBOs could benefit from increased testing capacity, and clients might benefit from more rapid access to education, counseling, and referrals. OraQuick's accuracy is comparable to the EIA. The oral swab rapid test could help HCV screening programs reach individuals unaware of their status and expand testing into nonclinical settings such as mobile units.