Despite implementation of universal Hepatitis B Virus (HBV) vaccination programme, HBV related chronic liver disease and Hepatocellular carcinoma (HCC) are major cause of morbidity and mortality in Asian Pacific region(APR). Currently eight drugs are approved for the treatment of chronic hepatitis B infection. These are 1) Interferon alpha 2a/2b 2) Lamivudine 3) Adefovir 4) Entecavir 5) Talbuviduine 6)Tenofovir 7) Peginterferon alpha 2a/ 2b 8) Thymocin alpha. Emcetrabine and Tenofovir are available for treatment of HBV and HIV co-infections. While selecting primary treatment agent a careful balance between long term benefits and long term risk should be evaluated. Long term benefits are in the form of antiviral potency and durability of response, while long term risks are side effects and drug resistance. While selecting the treatment important issues are 1) ease of administration 2) duration of treatment 3) costs of treatment and monitoring 4) Patient and provider preference & 5) contraindication. In real life scenario accessibility to treatment remains a significant challenge for many chronically infected adults in the APR. High cost and lack of reimbursement are the driving factors limiting effective diagnosis and treatment of chronic hepatitis B in the APR.