Chronic hepatitis B virus (HBV) is a significant threat to public health, with an estimated 296 million people living with the disease worldwide ( http://www.who.int/mediacentre/factsheets/fs204/en/ ). HBV and the associated complications, such as cirrhosis and hepatocellular carcinoma, cause >850,000 deaths yearly. Since the development of the HBV vaccine in the 1980s, new cases have decreased, yet the disease remains a global health concern, especially due to high rates of mother-to-child transmission (MTCT) in many countries ( http://www.who.int/mediacentre/factsheets/fs204/en/ ). The focus of this chapter is to explore the current management of hepatitis B in pregnancy, with an emphasis on treatment and prevention of transmission to the neonate.