Introduction: In 2008, the French Institute for Public Health Surveillance established a national surveillance system aimed at describing the epidemiological, clinical-biological, and histological characteristics of patients newly diagnosed with chronic hepatitis B in specialized hepatology units. Method: Adult patients who had not previously received antiviral treatment and were newly diagnosed with chronic hepatitis B between 2008 and 2011—defined by the persistence of the HBs antigen for at least 6 months—were included after obtaining consent. Epidemiological (sex, age, country of birth), laboratory (ALT, HBe antigen, viral load), and histological (assessment of hepatic fibrosis) data were collected. Results: Between 2008 and 2011, 3,672 patients were included: 59% were men; the median age was 36 years; 81% were born in a country with high (54%) or moderate (27%) hepatitis B endemicity; 70% were identified during a routine health screening. The viral load was ≤2,000 IU/mL in 58% of patients, ALT levels were normal in 72%, and HBeAg was negative in 87%. Cirrhosis or hepatocellular carcinoma was diagnosed in 11% of patients, with this proportion being higher among co-infected patients (HCV 41%; HDV 32%; HIV 31%), among heavy alcohol users (33%), or HBeAg-positive patients (21%). Conclusion: Chronic hepatitis B carriers should receive prompt care following diagnosis to assess liver damage and screen for associated comorbidities. Regular follow-up based on repeated measurement of ALT levels and HBV viral load is necessary to limit the risk of progression to hepatic complications (cirrhosis and hepatocellular carcinoma). (R.A.)