Recurrence is common for patients with chronic hepatitis B (CHB) who achieved hepatitis B virus (HBV) surface antigen (HBsAg) clearance after antiviral treatment. The aim of the study is to explore the possibility of quantitative hepatitis B core antibody (Anti-HBc) level as a biomarker to predict recurrence. A total of 73 patients with HBsAg clearance were enrolled in this study, 16 cases with recurrence and 57 cases of non-recurrence. A newly developed double-sandwich Anti-HBc immunoassay was used to detect the quantitative Anti-HBc level before therapy (baseline) and at the end of therapy. Logistic regression analysis was used to evaluate the predictive ability of quantitative Anti-HBc levels for recurrence. Quantitative Anti-HBc levels at the end of therapy in both recurrence and non-recurrence groups were significantly lower than those of before therapy (P < 0.001). In addition, the declining trend of the recurrence group was significantly greater than that of the non-recurrence group (0.71 log10 vs. 0.45 log10 IU/mL, P = 0.026). Quantitative Anti-HBc levels in non-recurrence group were higher than those in recurrence group at baseline and drug withdrawal (P = 0.023, P < 0.001). Multivariable analysis showed that Anti-HBc level at drug withdrawal alone was associated with recurrence (OR = 0.116, P = 0.037). At Anti-HBc level >2.3386 log10 IU/mL, the predictive sensitivity and specificity for recurrence were 80.0% and 71.9%. Quantitative Anti-HBc level can be used as a potential predictor of recurrence after HBsAg clearance. Anti-HBc level at the drug withdrawal has better predictive value than the baseline. Copyright © 2019. Published by Elsevier B.V.