We conducted a study in which 5,754 pregnant women who delivered at the Grace Maternity Hospital in Halifax were screened for HBsAg. There were five who were found to be seropositive for the first time (a screening yield for seropositivity of 8.7/10,000). Overall six were seropositive for a prevalence rate of 10.4/10,000. These rates are above the 6.0/10,000 level at which routine prenatal screening is considered to be cost-effective. Screening based upon risk factors would have identified only two of the five women who were found for the first time to be HBsAg seropositive. Based upon the results of this study, we recommend that routine screening for HBsAg be performed on all prenatal women in Nova Scotia.