Despite the development of successful vaccines against hepatitis B virus (HBV), Sierra Leone, like many countries lying within the geographical region where HBV infection is highly endemic, has yet to implement an immunisation or mass screening programme. However, certain sectors of the population could benefit from HBV screening if it was readily available and affordable. The use of a newly introduced immunochromatography (IC) test card for hepatitis B surface antigen (HBsAg) is examined for use among an ante-natal population in Sierra Leone, and compared with the existing reverse passive haemagglutination (R-PHA) method. The prevalence of HBsAg and hepatitis B envelope antigen (HBeAg) in the study population (n = 179) was 11.3% and 3.9%, respectively. The speed, sensitivity and simplicity of the IC method make it attractive, particularly for individual use and where laboratory facilities are minimal, but the cost of the test is comparatively high. In the African setting, pending the introduction of HBV vaccination into the Expanded Programme on Immunisation (EPI), the IC test card may be of use in the private sector where the turnover of patients is small, as a rapid means of detecting HBsAg in pregnant women who can afford both this facility and HBV vaccination of their newborn babies.