China has one of the world's highest rates of hepatitis B infection. Over the past 20 years, a series of strategies have been implemented to prevent infection with the hepatitis B virus (HBV) in China. These strategies include hepatitis B (hepB) immunization for susceptible populations such as infants and young children and for high-risk populations such as health care workers and patients, premarital health care for couples of childbearing age, and standard medical practices. A series of measures implemented by the Chinese government caused the HBV infection rate in China to decrease from 9.75% in 1992 to 7.2% in 2006. However, a report on infectious diseases indicated that more than 1 million people in China were infected with hepB in 2011. There is room for improvement. The current work analyzed the current status of and challenges for strategies to prevent HBV infection in China. This work also recommends clear guidance regarding hepB immunization for parents in rural areas, more flexible premarital health care, health education for both patients and health care workers, and routine HBV screening for high-risk health care workers.