Background: Hepatitis C virus (HCV) is a major health problem worldwide. Its long-term impact ranges from minimal damage to extensive fibrosis and cirrhosis, which is sometimes, accompanied by hepatocellular carcinoma (HCC). Objective: To evaluate early changes of hepatic fibrosis-related parameters in patients with chronic HCV patients using sonography-based real time elastography (RTE) and serum parameters as APRI, FIB4 before and after sofosbuvir-based antiviral therapy. Patients and methods: This study were conducted on 75 Egyptian patients with chronic hepatitis C who were collected from September 2019 and March 2020 at the National Hepatology and Tropical Medicine Research Institute Outpatient Clinics, Cairo, Egypt. Results: The mean age of the studied patients was 49.6±11.34years, 33 (44%)of them were males while 42 (56%) were females. A history of diabetes was reported in 9 (12%) patients, while 6 (8%) of our patients were hypertensive. A total of 75 HCV-infected patients treated with sofosbuvir based therapy for 12 weeks were identified, 62 (82.7%) were treated with sofosbuvir (400 mg/day) and daclatasvir( 60 mg/day) ,   13(17.3%)were treated with sofosbuvir( 400 mg/day )and daclatasvir( 60 mg/day) with weight-based ribavirin. Conclusion: Sofosbuvir-based treatment regimens for chronic hepatitis C resulted in significant reduction in liver stiffness measurements (LSM) by pSWE with significant changes in the distribution of patients receiving  triple therapy among the fibrosis stages and significant improvement in fibrosis scores (FIB4 and APRI) 12 weeks post treatment.