Background & Objective:Chronic B viral hepatitis is a major health problem worldwide. Several studies have reported that obesity is important risk factors altered immune system response in individuals with no underlying causes of liver disease. This study was to examine the correlation between body mass index, serum alanine aminotransferase activity and immunologic response in obese hepatitis B Saudi patients. Subjects and Methods: One hundred fifty Saudi male patients with hepatitis B viral infection (HBV); their age ranged from 30 to 45 (38.64 ± 7.12) years. Patients were divided in to two equal groups according to their body mass index: Group (A): Included patients with HBV, their body mass index (BMI) was greater than 30 kg/m 2 (the obese group). Group (B): Included patients with HBV, their BMI between 20 and 24 kg/m 2 (the normal-weight group). Results: An elevation of serum alanine aminotransferase (ALT) activity was found to be associated with increased BMI, also we observed an elevation with regard to the normal weight group in the parameters of white blood cells, neutrophils, monocytes, CD3, CD4 and CD8 for group A. CD3, CD4 and CD8 correlated with BMI only as a total amount, as well as with all measured parameters of blood count. Conclusion: Obesity adversely affects the immunological response and rate of disease progression in HBeAg-negative chronic hepatitis B viral infection. Body weight control is important in the management of patients with chronic hepatitis B viral infection.