BACKGROUND Hepatitis B status of pregnant women is essential for the effective management of the disease and prevention of mother to child transmission. AIM To determine the rate of HBeAg positivity among HBsAg positive pregnant women attending antenatal clinic in FMCA, to find out the significant risk factors in the development of Hepatitis B infection, to determine the knowledge base of participants about HBV infection and to determine the rate of mother to child transmission of Hepatitis B virus. METHODOLOGY This was a longitudinal cohort study carried out in the ante-natal clinic and labour ward of the Department of Obstetrics and Gynaecology of Federal Medical Center, Abeokuta. HBsAg positive pregnant women presenting for routine ante-natal clinic were recruited. A repeat HBsAg screening using ELISA method was carried out to eliminate false positives. Questionnaires were administered to HBsAg positive women and equally matched number of HBsAg negative women to determine significant risk factors and to assess the knowledge of participants on HBV infection. HBV infected mothers were co-managed with the gastroenterologists and they were counselled to procure Hepatitis B immunoglobulin to passively immunize the newborn irrespective of their HBeAg status. Maternal and cord blood samples were collected at delivery to determine HBV sero-markers. Infants of these mothers were also tested at three months of life for HBV seromarkers to determine the perinatal transmission of HBV.