Clinical management of chronic hepatitis B is rapidly evolving after the recent development of new antiviral drugs. These agents have been shown to be effective in improving virological, biochemical, and histological features in high proportion of the patients with chronic hepatitis B. However, these drugs can not eliminate hepatitis B virus (HBV) directly. It can only suppress HBV replication. Furthermore, the emergence of drug resistant HBV has become problematic according to the long-term use of oral antiviral drugs. Therefore, physicians should be careful in selecting whom to treat, when to start treatment, how long to treat, how to monitor patients before, during and after the treatment, which drug to choose, and how to manage patients with drug resistance. This review will focus on the monitoring and treatment strategy for chronic hepatitis B and drug resistant hepatitis B, quoting some clinical data of recently introduced or promising future drugs.