Occult hepatitis B infection is defined as the presence of HBV DNA in serum and/or the liver tissue without detectable HBsAg with or without anti-HBc or anti-HBs antibodies. In Egypt many studies on occult hepatitis B have been conducted and this infection is well established in various patients groups. This short review sheds light on the occurrence of occult hepatitis B infection among different disease states in Egypt. The coexistence of occult hepatitis B with hepatitis C infection is of particular importance because of its added co-morbidity of liver enzymes elevation, increased severity of liver disease and increased risk of hepatocellular carcinoma. Patients on regular hemodialysis and those exposed to blood transfusion are at high risk of acquiring this form of infection. The highest prevalence of occult hepatitis B virus in Egypt was reported among patients with hepatocellular carcinoma and similar to the scenario for classic hepatitis B infection, genotype D is the most prevalent genotype.