Hepatitis E must no longer be considered simply as an exotic disease occasionally imported from developing countries. Autochthonous hepatitis E exists in France. In spite of certain difficulties and limits, biological markers of hepatitis E have to be included in algorithms for etiological diagnosis of acute hepatitis, even if the patient has not recently traveled abroad. Based on a recombinant protein of the viral capsid, more sensitive serological assays should soon be available. The potential severity of hepatitis E, especially during pregnancy, calls for a national surveillance program, including evaluation of the animal reservoir and the risk associated with drinking water and food.