Vertical transmission of HBV from mother to their offspring and perinatal transmission of HBV after birth are two main routes of HBV transmission in most of the developing countries. On the other hand, HBV flare may be seen in some patients during their pregnancy. HBV should be routinely checked in pregnant subjects so that the HBV-infected pregnant mother can be properly managed. This is also important for giving a safe delivery. Even with HBV-infected mother, vertical transmission can be blocked to children by using HBIG and HB vaccines. In addition, hepatitis B flare may happen after delivery. Thus, several aspects about HBV should be properly addressed to have a safe delivery from the point of safety of both mother and the off spring. The present chapter has provided an outline about HBV in pregnancy.