Background and aim: The outcome of hepatitis B virus (HBV) infectionacquired in childhood is uncertain because of the diversity of theepidemiological and clinical features of infection and disease. The aim of thisstudy was to determine the outcome of HBV infected attendees of hepatologyclinic at Cairo University Pediatrics Hospital (CUPH).Methods: The data of 73 HBV infected Egyptian children presenting to theCUPH between 1992-2006, were retrospectively analyzed for risk factors aswell as clinically, serologically and histologically with a mean duration offollow up of 6.3±3.4 years.Results: Results revealed that there were 57.5% HBsAg+ve cases, the meanage at presentation was 6.3±4.4 years. History of blood transfusion was found in11 (26.2%) children, history of HBV infected mothers was found in 10 (23.8%)children, and elevated ALT level was found in 33 (78.6%) cases at presentation.Chronic hepatitis was present in 62%, 23.8% had fibrosis, and 19% ofHBsAg+ve cases had cirrhosis.Conclusion: Blood transfusion remains a major risk of HBV transmissionamong Egyptian children. Among the HBsAg+ve cases ALT levels are elevatedin three quarters and histopathological abnormalities are detected in about twothird of HBsAg+ve cases. During follow up 43% of HBsAg+ve cases wereseroconvert from HBsAg+ve to HBsAg-ve with HBsAb+ve.