Abstract: To study the relation of liver inflammation grades to the effect of Lamivudine in chronic hepatitis B, 83 patients were enrolled and randomized into three groups according to the serum level of ALT--ALT<2×upper limit of normal (ULN) , 2～5ULN?>5ULN, among them, 21 patients received hepatic biopsy. All the patients received 100mg Lamivudine every day orlly for 12 months. The rares of ALT recovery, HBV DNA conversion negative, HBeAg negative conversion and HBeAg/anti-HBe seroconversion were 65.06%, 77.11%, 55.55% and 30.91% respectively. The total clinical response rate was 85.54%. The results showed that the rates of ALT recovery, HBeAg negative conversion and clinical effect were positive related to the inflammation grades, and the HBV DNA negative conversion rate and HBeAg/anti-HBe seroconversion rate were not related to it. The higher of the inflammation grades, the better effect of Lamivudine.