Pregnancy with chronic hepatitis B virus infection (HBV) is a unique management issue. We need to consider the impact of HBV infection on pregnancy, the impact of pregnancy itself on chronic HBV infection, and the treatment of hepatitis B during pregnancy and measures for mother-to-child interruption. In the population of pregnant women, chronic HBV infection is often mild but is likely to present with a hepatitis flare-up after delivery. Chronic HBV infection often has no significant effect on pregnancy outcome, but this depends largely on the severity of liver disease. Current immunoprophylaxis can reduce the rate of mother-to-child transmission significantly; however, hypervirulent pregnant women may be a major reason for the failure of immunoprophylaxis. Antiviral therapy during pregnancy is yet to be individualized. Pregnancy in women with chronic hepatitis B requires careful planning and management.