A Morbidity and Mortality Weekly Report (MMWR) published in January 2016 describes an emerging hepatitis B epidemic in Kentucky, Tennessee, and West Virginia. Since 2009, these Appalachian states have reported an increase in cases of acute HBV infection among non-Hispanic whites, persons aged 30–39 years, and injection drug users. Almost half of these new cases were in non-urban areas. Compared with cases that occurred during 2006–2009, a significant increase in the proportion of cases in which injection drug use was reported during 2010–2013. Overall, the national incidence of hepatitis B infection (HBV) has remained stable and as many as 2.2 million people are infected chronically in the United States. The increase in incident HBV could potentially impede the nation’s hepatitis B elimination strategy. Evidence-based prevention strategies, including increasing hepatitis B vaccination coverage, testing and linkage to care, and implementing education campaigns that target persons who inject drugs, are needed. Read the MMWR here.