AIM:To determine the seroprevalence of Hepatitis A (HAV) amongst Saudi children and compare it with previously reported prevalence data from the same population.METHODS:A total of 1357 students were randomly selected between the ages of 16 and 18 years (689 males and 668 females) from three different regions of Saudi Arabia (Madinah,Al-Qaseem,and Aseer) and tested for anti-HAV-IgG.RESULTS:The overall prevalence of anti-HAV-IgG among the study population was 18.6%.There was no difference between males and females but there was a significant difference in the seroprevalence (P=0.0001) between the three different regions,with Madinah region showing the highest prevalence (27.4%).When classified according to socioeconomic status,lower class students had a prevalence of 36.6%,lower middle class 16.6%,upper middle class 9.6%,and upper class 5.9% (P=0.0001).Comparing the current study results with those of previous studies in 1989 and 1997 involving the same population,there was a marked reduction in the overall prevalence of HAV from 52% in 1989,to 25% in 1997,to 18.6% in 2008 (P＜0.0001).CONCLUSION:Over the last 18 years,there has been a marked decline in the prevalence of HAV in Saudi children and adolescents.The current low prevalence rates call for strict adherence to vaccination policies in high-risk patients and raises the question of a universal HAV vaccination program.