Abstract: Objective To detect serum neopterin level in hepatitis B virus carrier among children and explore the relation between serum neopterin level and HBV DNA load. Methods The serum neopterin and HBV DNA load were detected for 150 children who were hepatitis B virus carriers and 60 healthy children by using enzyme linked immunosorbent assay (ELISA) and real-time fluorescence PCR. Results Compared with healthy children and inactive HBsAg carriers, the serum neopterin level was significantly higher in children with chronic HBV infection, the difference was statistical significant(P0.05), the difference on serum neopterin level between inactive HBsAg carrier and healthy children had no statistical significance(P0.05). There was no significant correlation between neopterin level and HBV DNA load(r=0.131,P0.05). Conclusion Compared with inactive HBsAg carrier, immune cells were more easily activated in children with chronic HBV infection, more attention should be paid to chronic HBV carrier during the follow-up. The increase of neopterin level could indicate the presence of virus replication, but not the quantity of the HBV DNA load.