AIM:To assess the prevalence and socio-demographic distribution of hepatitis B virus (HBV) infection in Albania. METHODS: Blood samples from 410 unselected schoolboys, 666 students, 500 military personnel, 1286 casual blood donors, 378 voluntary blood donors and 640 pregnant women (total 3880 non-vaccinated residents of rural and metropolitan areas from all over Albania; 2354 (60.7%) male and 1526 (39.3%) female; mean age of 26.3 years) were tested during 2004-2006 for hepatitis B surface antigen (HBsAg) and antibodies to hepatitis B virus (anti-HBs) by ELISA. RESULTS: The HBsAg and anti-HBs prevalence were 9.5% and 28.7%, respectively. The highest HBsAg prevalence was evident in the younger age group, such as in schoolchildren (11.8%) and the military (10.6%).Consequently, the anti-HBs prevalence increased with age, from 21.2% in schoolchildren (mean age: 15.7 years), to 36.3% in pregnant women (mean age: 26.3 years) and 29.7% in voluntary blood donors (mean age: 40.1 years). There were no significant differences between males and females. CONCLUSION: Despite the estimated two-fold reduction of HBsAg prevalence in the general population from about 18%-19% to 9.5%, Albania remains a highly endemic country (I.e. Over 8% of HBsAg prevalence rate).