Background: Hepatitis A is a disease endemic in many areas of the world. Greece is considered a country of intermediate endemicity, but recent data are lacking. A national cross-sectional seroprevalence survey was conducted to evaluate the current seroepidemiology of hepatitis A in children in the age group 0-14 years living in Greece.Methods: Using the ESSEN II methodology, 100 sera per year of age, stratified by geographic region, were collected and tested for the presence of anti-HAV IgG antibodies (AXSYM, Abbott Laboratories). Data from 1,393 children were analyzed.Results: Immigrant children and children residing in rural areas were significantly less likely to be immunized. Among unvaccinated children, the seroprevalence was 17.07%. Nationality had a marginally significant effect, since nonimmunized immigrant children had a higher seroprevalence rate (22.38% versus 15.9%, OR=1.52, p=0.064). Significant differences were observed between geographic areas in both vaccination coverage and natural immunity.Conclusions: These data indicate that hepatitis A continues to prevail in Greece and therefore universal infant immunization should be considered.