Approximately 500000 individuals in Germany are chronically infected with hepatitis B of which most have been still not diagnosed or adequately treated. Patients with chronic hepatitis B are at risk to develop advanced liver fibrosis and cirrhosis and subsequently hepatocellular carcinoma. National and international guidelines should be valued as a practical help in the management of these patients. By the end of 2007 a national German hepatitis B guideline has been published, followed by a Clinical Practice Guideline of the European Association for the Study of the Liver (EASL) in 2009. An update of the National German guideline was published in the mid of 2011. The recommendations of these guidelines are delineated. Most importantly the management of hepatitis B remains complicated and needs very experienced hepatologists.