Objectives: Hepatitis B virus (HBV)-related chronic liver disease is a common health problem in our country. About 5.2 to 7.8% population of Bangladesh is chronic HBV carriers. There is no long-term follow-up study of asymptomatic HBV carriers in our country. Aim of the present study is to know the outcome of these cases in 10 years. Materials and methods: Twelve hundred and eighty-six cases of asymptomatic HBsAg-positive individuals were evaluated and followed up for 10 years at gastroenterology department, combined Military Hospital, Dhaka Cantonment, from January 2000 to December 2009. Results: Age of the patient’s ranges from 3 to 50 years (mean, 27 ± 6 years). Majority cases were males 1,236 (96.12%). Baseline alanine aminotransferase (ALT) >45 IU/l was found in 168 (13.06%) cases. Ultrasonography revealed coarse hepatic echotexture in 62 (5.63%) cases out of 1,200 cases. Hepatic histology revealed chronic hepatitis in 318 cases (35.02%) and cirrhosis of liver in 24 cases (2.64%), hepatocellular carcinoma 1 (0.11%), fatty liver in eight (0.88%) out of 908 cases. After follow-up, compensated cirrhosis of liver was found in 90 (15%) cases, decompensated liver disease in 50 (8.33%) cases and hepatocellular carcinoma (HCC) in 42 (7%) out of 600 cases. Twenty (3.33%) cases died due to liver failure, HCC and other complications. Spontaneous HBsAg seronegativity occurred in five cases out of 600 cases (0.83%), and spontaneous HBeAg seroconversion occurred in 10 cases out of 180 cases (5.55%). Conclusion: Asymptomatic HBsAg-positive carriers should not be considered as inactive disease. They should be followed up every 3 to 6 months to know activity of the disease and development of complications. Antiviral treatment should be instituted in cases of active liver disease.