Background Hepatitis B virus (HBV) infection remains a significant global health challenge particularly in developing countries and regions. Gezira State, Sudan where prevalence and disease burden are high is an example of such regions. This study aimed to quantify HBV viral load among patients in Gezira State and assess the distribution of viral loads across demographic groups, including gender and age. Method A descriptive cross-sectional study was conducted between January 2022 and January 2023. Randomly selected 100 chronic HBV patients were enrolled from major healthcare facilities in Wad Medani, Gezira’s capital. Viral loads were measured using real-time PCR, and statistical analyses were performed to identify predictors of high viral load. Results The results revealed that the mean HBV viral load was 886,363 IU/ml (SD± 421,295), with a significantly higher mean in males (1,122,899 IU/ml) compared to females (531,559 IU/ml) (p< 0.0001). Viral loads ranged from 15 IU/ml to 35,474,488 IU/ml, with 37% of patients exceeding the WHO-recommended treatment threshold of 2,000 IU/ml. However, no significant association was found between viral load and age (p=0.939). Conclusion The study highlighted the need for gender-specific management strategies and the importance of HBV viral load quantification for effective public health intervention in Gezira State. Further research is recommended to explore HBV epidemiology in Sudan more comprehensively.