Objectives: We developed an enhanced surveillance system for hepatitis B to improve the detection of newly acquired cases and to collect epidemiological data. Methods: The study was undertaken from February to June (inclusive) 2005 at the Sydney South West Area Health Service Eastern Zone Public Health Unit. A letter was sent to treating doctors on receipt of a notification, requesting additional information on cases. Cases identified by the treating doctors as newly acquired were followed up by telephone. Results: There were 295 notifications of hepatitis B in the period, of which three were newly acquired infections. Only one of these three cases was identified through enhanced surveillance. Information on ethnicity was obtained. Conclusions: This enhanced surveillance system is of limited value as an ongoing process. We recommend that it be undertaken periodically to monitor the epidemiology of the disease.