Abstract: It is about to enter the decisive five years of the 2030 goal set by the World Health Organization to eliminate hepatitis. As one of the countries with the heaviest burden of hepatitis B virus, China faces self-evident challenges. Hepatitis B vaccination has been scientifically verified as the most powerful weapon to eliminate hepatitis B at present. Since 1992, the hepatitis B vaccination strategy has been implemented and continuously improved in China, achieving remarkable success. Accordingly, significant progress has been made in the prevention and control of hepatitis B in China. However, up to now, China still faces multiple problems to be solved in hepatitis B vaccination, and it is particularly urgent to further improve the hepatitis B vaccination strategy. This review aims to provide a useful reference for the continuous optimization of hepatitis B vaccination strategies in China by reviewing the evolution of hepatitis B vaccination strategies in China, delving into the current status of vaccination, analyzing the main challenges that still exist, and making an outlook on the future development of hepatitis B vaccination strategies.