Objective: To analyze the distribution characteristics and trends of hepatitis B in Harbin and provide evidence for the development of hepatitis B prevention and control strategies. Methods: Descriptive epidemiological methods were used to analyze the three-dimensional distribution characteristics and epidemiological trends of hepatitis B data in Harbin from 2010 to 2023. Results: A total of 38,604 cases of hepatitis B were reported in Harbin from 2010 to 2023, with an average annual incidence rate of 26.38 per 100,000. The majority of hepatitis B cases were chronic. There was no obvious seasonal distribution pattern of hepatitis B. The average incidence rate was lowest in the < 10-year-old group (1.72 per 100,000) and highest in the 40-year-old group (34.71 per 100,000). Cases were mainly concentrated in the 30-69-year-old population, accounting for 75.35%. The male-to-female ratio was 1.35:1. The majority of cases were farmers, accounting for 57.31%. Conclusion: Except for a significant decrease from 2020 to 2022, the overall incidence of hepatitis B showed a trend of decreasing first and then increasing from 2010 to 2023. The prevention and control measures for the 0-19-year-old population were effective. It is necessary to strengthen the prevention and control of hepatitis B among adults over 20 years old, especially to develop differentiated hepatitis B prevention and control strategies targeting key areas and high-risk populations.