Abstract: Objectives To investigate the outcomes of neonatals with abnormal hepatitis B virus (HBV) serological markers. Methods Twenty-eight neonatals who had abnormal HBV serological markers and whose mothers had positive HBsAg, HbeAg and HbcAb were studied. Among them, 21 neonatals who had positive HBsAg, HbeAg and HbcAb were included in vertical transmission group; 7 neonatals who had positive HbeAg, HbcAb and negative HBsAg were included in suspicious group. The quantities of HBV serological markers were determined by time-resolved immunofluorometric assay (IFMA) and the level of HBV DNA were measured by fluorescence quantitative PCR (FQ-PCR). Results Serum HBeAg and HBsAg levels in suspicious group were lower than those in vertical transmission group (P<0.05). The results showed that HBeAg level (0.55±0.19 PEIU/ml) three months after birth was lower than that (4.02±2.00 PEIU/ml) 7 days after birth in suspicious group (P<0.05). Conclusions Early interference has positive effect in mothers and neonatls with abnormal HBV serological markers.