In the United States, reported acute hepatitis B infections steadily declined from 18,003 cases in 1991 to 8,036 cases in 2000. Despite this decline, hepatitis B is a significant concern to the Veterans Health Administration (VHA) of the Department of Veterans Affairs because of the need for care of veterans afflicted with this disease and the VHA health care workers at risk for occupational exposure to hepatitis B virus. On an annual basis from federal fiscal year (FY) 1991 through FY 2001, the VHA Infectious Diseases Program Office requested information from patient care sites regarding hepatitis B. The reported number of patients with acute hepatitis B ranged from 446 to 749 during this period. This translates into a case rate per 100,000 veterans served of 29.15 and 12.68 for FYs 1991 and 2001, respectively. The number of persons with a positive hepatitis B surface antigen test during this 11-year period ranged from 2,688 to 3,100, suggesting a sizeable pool from which occupational exposure may occur. The rate of decline in the cases of acute hepatitis B in the VHA is more than that seen nationally in the United States.