Hepatic cirrhosis is the endpoint of a variety of liver diseases, from Hepatitis B to hemochromatosis, and leads to the life-threatening complications of decompensated cirrhosis and hepatocellular carcinoma. In patients with known liver disease, who are in the process of active inflammation and resultant scarring, the ability to follow various stages of fibrosis with non-invasive serum markers and novel diagnostic modalities such as elastography is very appealing. The development of hepatic fibrosis could then be detected earlier and followed regularly, with implementation of therapy to curtail or even reverse fibrosis before significant scarring has occurred. This has the potential to positively influence the care of patients with chronic liver diseases.