Objective To assess the value of high-frequency ultrasonography scoring system in assessing liver fibrosis of hepatitis B Method This was a retrospective study from January 2015 to October 2017. Patients with hepatitis B were performed by ultrasound with a 9-3MHz linear transducer (iU22,Philips Healthcare, Andover, MA) for evaluation of liver stiffness prior to surgery, and the features of liver capsule and liver parenchyma were scored and the scored values were comparatively analyzed with the staging of the pathological liver fibrosis. Pathologic findings of liver fibrosis were classified as S0, S1, S2, S3, and S4, according to Scheuer’s scoring system. Spearman correlation test was used to determine the relationship between ultrasound scoring system and fibrosis. The area under receiver operating curve (AUROC) was used to assess the diagnostic performance of ultrasound scoring system. The relationship between high-frequency ultrasonography scoring system and liver fibrosis stage were investigated. Results A total of 1795 CHB patients were included in this study. The correlation coefficient between high-frequency ultrasonography integrated score and fibrosis stage was 0.745 (P<0.05). The AUROC of high-frequency ultrasonography integrated score in assessing significant liver fibrosis (≥S3) and liver cirrhosis(S4) were 0.920(0.906-0.932), and 0.881(0.866-0.896), respectively, which were better than the scores of liver capsule and liver parenchyma(P＜0.05). The score to detect liver fibrosis stage S3 and S4 were 3 and 4 as high-frequency ultrasonography integrated score respectively. Conclusion High-frequency Ultrasonography is a reliable method for assessing liver fibrosis in patients with CHB, especially in significant fibrosis.