Transient elastography (TE, Fibroscan) is a recent, rapid and highly reproducible technique for measuring liver tissue stiffness. Several studies in patients with chronic liver disease evidenced that it accurately predicts the degree of hepatic fibrosis and that it is particularly accurate in identifying severe fibrosis and cirrhosis. However, in the clinical practice TE provides an answer to a single question (liver elasticity) that could be influenced by several factors, mainly by hepatic fibrosis, but also by necrosis-inflammatory activity and extrahepatic cholestasis.