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1 IntroductionLiver fibrosis is a scar forming process which results from the repair and proliferation of liver tissue associated with increased deposition of extracellular matrix (ECM) in liver after diverse liver injuries.A liver biopsy remains the gold standard for assessing liver fibrosis.However,liver biopsy is an invasive procedure with several limitations.Direct serum markers are used for assessing the degree of liver fibrosis and guiding treatment in clinical practice.Serum HA levels were more clinically useful for diagnosing and predicting the absence or presence of significant fibrosis than mild and moderate fibrosis.The increase of serum PIIINP levels prompted active liver fibrosis in the early stage of CLD and reflected the activity of inflammation.Serum CIV levels significantly increased with the early progression of fibrogenesis and serum laminin has a strongly positive correlation with the degree of portal hypertension.Non-patented serum marker indexes are more used in clinical practice when patented.But none of these can exactly reflect liver fibrosis.