Abstract: Group B Streptococcus (GBS) is the leading cause of newborn infection. GBS colonizes pregnant women worldwide and GBS can colonize in their maternal genitourinary and urogenital tracts. GBS can transit from an asymptomatic commensal member of the mucosal biome to a pathogenic bacterium under certain conditions, causing a high burden of neonatal and infant disease globally. Although antepartum screening for GBS and intrapartum antibiotic prophylaxis reduced the incidence of perinatal GBS disease, there are still many problems in practice, such as long testing time, delayed antibiotics use, and antibiotic resistance. This review introduces GBS colonization, biological characteristics, epidemiology, antepartum screening, intrapartum antibiotic prophylaxis, and the current status of vaccine development. Implementing vaccination for pregnant women may be a promising strategy to prevent neonatal and infant GBS disease. In combination with standardized and effective screening and intrapartum antibiotic prophylaxis, vaccination is expected to significantly reduce the morbidity of maternal and neonatal GBS disease.