Summary Background Grey Zone (GZ) is an ill‐defined situation including patients falling between inactive carrier (IC) state and HBeAg‐negative chronic hepatitis B (HBeAg‐negative CHB). Aims To assess the long‐term outcomes of GZ patients compared to IC in the absence of treatment. Methods Retrospective analysis of 287 IC and GZ HBeAg‐negative patients. Patients were classified into 4 groups at baseline: HBV‐DNA <2000 IU/mL and ALT <40 U/L (IC), HBV‐DNA <2000 IU/mL and ALT 40‐80 U/L (GZ‐1), HBV‐DNA 2000‐20 000 IU/mL and ALT <40 U/L (GZ‐2) or ALT 40‐80 U/L (GZ‐3). Data were also analysed using AASLD ALT criteria. Results After a median follow‐up of 8.2 (5‐19) years, HBsAg loss occurred in about 15% ICs or GZ patients. Transition into IC state occurred in 40% of GZ patients. DNA fluctuations >2000 IU/mL correlated inversely with transition into IC and HBsAg loss. HBsAg levels were significantly lower in ICs than in GZ patients (338 IU/mL 20‐3269 vs 5763 IU/mL 2172‐17 754; P < 0.05). Among the latter group, there was an increasing gradient of HBsAg levels from GZ‐1 to GZ‐3 patients (P < 0.05). HBeAg‐negative CHB occurred in only 18 (6.3%) GZ patients. No patient developed cirrhosis nor advanced fibrosis. ALT/HBV‐DNA fluctuations and HBeAg‐negative CHB development were more frequent in genotype B/C patients, whereas HBsAg loss occurred only in genotype A/D patients. Conclusions Most Caucasian GZ patients present excellent long‐term outcomes in the absence of treatment, with a high rate of HBsAg loss and low rate of progression to HBeAg‐negative CHB. HBV‐genotyping and HBsAg levels could help to predict outcomes and better classify GZ patients. Linked ContentThis article is linked to Ridruejo paper. To view this article visit https://doi.org/10.1111/apt.14644.