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Introduction: The assessment of the severity of liver damage determines the prognosis and therapeutic indications in chronic hepatitis B. Liver biopsy is currently considered to be the reference test for assessing the extent of fibrosis and inflammation, however it has certain limitations. Objective: To evaluate and compare the diagnostic performance of pulse elastometry (EI), FIB4, APRI and GPR to predict significant fibrosis during chronic hepatitis B in a Tunisian population.Methods: Prospective analytical study, spread over a period of 3 years from January 2015 to December 2017, carried out at the gastroenterology department of the Sahloul University Hospital Center of Sousse on patients followed for chronic hepatitis B. FIB4, APRI and GPR scores were calculated and the AE performed in all patients.