Equine hepacivirus (EHCV; nonprimate hepacivirus) is a hepatotropic member of the Flaviviridae family that infects horses. Although EHCV is the closest known relative to hepatitis C virus (HCV), its complete replication kinetics in vivo have not been described, and direct evidence that it causes hepatitis has been lacking. In this study, we detected EHCV in 2 horses that developed post-transfusion hepatitis. Plasma and serum from these horses were used to experimentally transmit EHCV to 4 young adult Arabian horses, two 1-month-old foals (1 Arabian and 1 Arabian-pony cross), and 2 foals (1 Arabian and 1 Arabian-pony cross) with severe combined immunodeficiency (SCID). Our results demonstrated that EHCV had infection kinetics similar to HCV and that infection was associated with acute and chronic liver disease as measured by elevations of liver-specific enzymes and/or by histopathology. Although most of these animals were coinfected with equine pegivirus (EPgV), also a flavivirus, EPgV viral loads were much lower and often undetectable in both liver and blood. Three additional young adult Arabian-pony crosses and 1 SCID foal were then inoculated with plasma containing only EHCV, and evidence of mild hepatocellular damage was observed. The different levels of liver-specific enzyme elevation, hepatic inflammation, and duration of viremia observed during EHCV infection suggested that the magnitude and course of liver disease was mediated by the virus inoculum and/or by host factors, including breed, age, and adaptive immune status. Conclusion: This work documents the complete infection kinetics and liver pathology associated with acute and chronic EHCV infection in horses and further justifies it as a large animal model for HCV. (HEPATOLOGY 2015;61:1533-1546 H epatitis C virus (HCV), a member of the Hepacivirus genus in the family Flaviviridae, is estimated to persistently infect 150 million people throughout the world, and is a leading cause of cirrhosis and hepatocellular carcinoma. Development of a vaccine that prevents persistent infection is an important goal, but significant challenges to prophylaxis include viral immune escape, antigenic diversity of different viral strains, and the limitations of current mouse models for studies of HCV infection, progression, and vaccine development.1,2 Although humans are the only natural hosts for HCV, chimpanzees can be infected with HCV, develop similar clinical disease as humans, and currently represent the best model for vaccine studies.1 However, owing to the proposed listing of all chimpanzees as endangered and the resulting phase out of the use of chimpanzees in research, 3 alternative animal models are needed. Small animal models in which to dissect correlates of vaccine-mediated protection against HCV would have distinct advantages, but in their absence, alternative large animal models deserve consideration. Recent work has identified unique hepaciviruses and viruses of the closely related genus Pegivirus in rodents, bats, and