In this study, we sought to establish whether there was an association between adult attachment style and number of medically unexplained physical symptoms in patients with hepatitis C. Thirty-two patients with hepatitis C were assessed with regard to attachment style classification, number of lifetime medically unexplained symptoms, lifetime psychiatric diagnoses, medical comorbidity, disease severity, use of interferon, and demographic characteristics. Analysis of covariance was used to compare the four attachment groups on number of lifetime medically unexplained symptoms, and Pearson correlations were used to assess the association of continuous ratings of attachment style with lifetime medically unexplained symptoms. Number of lifetime medically unexplained symptoms varied significantly as a function of attachment style group, with patients with fearful attachment reporting significantly more medically unexplained symptoms than patients with secure attachment (P < 0.01). Number of lifetime medically unexplained symptoms was positively correlated with continuous ratings of fearful attachment (r = 0.53, P < 0.01) and preoccupied attachment (r = 0.46, P < 0.01). Implications for treatment are discussed.