The prevalence of hepatitis B among the Canadian Inuit population is 4\%. This study will use a mathematical model to compare the roles of vaccination and therapy to predict future prevalence and incidence among the Canadian Inuit population for the next 50 years. We applied a mathematical model developed by Medley et al. (Nat Med 7(5):619-624, 2001), combined with data on hepatitis B incidence, prevalence, and vaccination coverage, to predict trends of hepatitis B virus (HBV) among the Inuit population over the next 50 years. The current estimated prevalence of HBV is 6.04\% and the incidence is 3.4/100,000 persons among Canadian Inuit. If HBV vaccination coverage levels of 47.2\% remain unchanged, the prevalence of HBV will decrease to 1.91\% and the incidence will decrease to 0.81/100,000 persons by 2058. If vaccination coverage levels are increased to 57.2\%, the prevalence and incidence of HBV will decrease to 1.74\% and 0.63/100,000 persons, respectively. If we increase both immunization and therapy by 10\%, this will produce the greatest reduction in prevalence and incidence, to 1.56\% and 0.54/100,000 persons, respectively. The combination of immunization and treatment programs seems to have the best result in decreasing the prevalence and incidence of HBV among the Inuit population.