Background: Ultrasound elastography is a novel and promising noninvasive method based on sonography for assessing liver fibrosis in persons with chronic viral hepatitis. Objective:The aim of the current work was to assess the effectiveness of ultrasound elastography as a non-invasive alternative method of liver biopsy for the diagnosis and staging of hepatic fibrosis in people with chronic liver disease. Patients and methods: This study included a total of 50 patients with chronic HCV who had been identified by using PCR testing for HCV RNA and seropositivity for HCV antibodies, attending at Theodor Bilharz Research Institute (TBRI). Prior to starting treatment, patients were referred for evaluation and underwent abdominal ultrasonography, ultrasound-guided liver biopsies, and real-time elastography (RTE) to quantify the stiffness of the liver. Results: liver fibrosis index (LFI) and stage of liver fibrosis identified by very sensitive liver biopsy showed a significantly positive connection (ranging of sensitivity from 86.36 % to 100%) and high specificity ranging from (78.57 % to 89.36%). High sensitivity and specificity was observed specially in high grades of fibrosis ≥F3 and F4. For determining the extent of liver fibrosis in CHC patients, RTE shown a high level of performance utilizing LFI, and it proved to be notably helpful for the identification of early cirrhosis and advanced hepatitis, both of which are issues in clinical practice. Additionally, it contrasted well with the reported pooled TE performance. Conclusion: It could be concluded that the future of elastography imaging is optimistic, and RTE appears to be a promising method since it can yield a good diagnostic performance to predict advanced fibrosis in CHC, and to detect hepatic fibrosis staging.