ABSTRACT Objective To explore the value of superb microvascular imaging(SMI) to the diagnosis of chronic hepatitis B. Methods We recruited 57 patients with biospy-proven chronic hepatitis B , Useing the SMI to assess the vascular pattern in the vicinity of the liver surface. SMI images were classified into five groups accoriding to the vascular pattern and SMI vascular score was performed , and these patterns were compared with the fibrosis stage. The correlation between the degree of liver fibrosis and the vascular pattern in the vicinity of the liver surface were assessed.Results The SMI score was higer in patients with advnced liver fibrosis(S3 or S4,2.72±0.98) than those with mild-to-moderate liver fibrosis (S1 or S2,1.63±0.87). When the optimal cut-off value was 2.5, the AUC for advnced liver fibrosis was 0.783, and the sensitivity and the specificity were 60.0% and 83.3%. Liver fibrosis stage and the SMI vascular pattern have a high degree of positive correlation (Gamma=0.799>0, P<0.001). Conclution SMI appears to be a reliable tool to predict the extent of HBV liver fibrosis noninvasively by detecting the vascular pattern in the vicinity of the liver surface.