Objective To establish noninvasive semiquantitative ultrasonic criteria for evaluating liver fibrosis and differentiating cirrhosis from chronic hepatitis. Methods A total of 66 HBsAg positive patients (chronic hepatitis 42 patients, cirrhosis 24) were included. Ultrasonography was performed 24 hours before liver biopsy. A fibrotic scoring system was used to evaluate the ultrasound findings in contrast with fibrotic stages in each patient. Results The total liver fibrotic scores had a significantly positive correlation with the histological liver fibrotic stage (r = 0.952, P < 0.001); the stage of histological liver fibrosis (Y) was calculated by the total fibrotic scores (X according to the experiential formula: Y = X/2 - 2; receiver operating curves (ROC) showed that the best cut-off values for differentiating cirrhosis from chronic hepatitis was 10 with a sensitivity of 87.8% and a specificity of 97.6%. Conclusions The total fibrotic scores of ultrasonic dimentional image provide a semiquantitative marker to evaluate liver fibrosis and differentiate cirrhosis from chronic hepatitis.