Background: Although there are effective vaccines and treatment strategies against hepatitis B, it is still a significant health concern in Serbia and worldwide. Methods and Objectives: The objective was to assess epidemiological characteristics, incidence and trend of hepatitis B in the Nišava District in the period 2011-2020. Descriptive epidemiological method was applied. Data for the study were provided by Annual Reports of Communicable Diseases of the Institute of Public Health Niš. Incidence rates (IR) were calculated per 100,000 inhabitants. Results: A total of 496 HBV cases were registered (60% males and 40% females). Majority of cases were reported as HBV carriers (56%), while 25% as acute HBV, and 19% as chronic. The male-tofemale ratio was 1.5:1. The average annual IR was 12.6, while 15.4 was in males and 10.0 was in females. Incidence trend has decreased. The highest IR for HBV carriers (97.4), acute HBV (56.2) and for chronic (37.5) was registered in the age group 30-39, while the lowest found in the age group 5-9 for HBV carriers (5.6), 0-9 for acute HBV (0.0) and 5-14 for chronic HBV (0.0). The highest IR were reported in the municipalities of Niš (14.7) and Aleksinac (13.3) while the lowest found in the municipalities of Gadžin Han (3.6) and Ražanj (2.2). Conclusions: Incidence continued to decline over the last ten years, which is in accordance with global and Serbia trends. There is a need to improve quality of reporting and surveillance data in monitoring the epidemiological situation of the hepatitis B.