Liver fibrosis is the main determinant of clinical outcomes of chronic hepatitis C. Liver biopsy is still considered the gold-standard for assessing liver fibrosis. However, liver biopsy is an invasive procedure associated with morbidity and mortality and has several limitations. Moreover, liver biopsy is not well accepted by the patients, especially when repeated examinations are needed, and its accuracy in assessing fibrosis is questionable due to sampling errors, intraobserver and interobserver discrepancies. Therefore, over the last years there has been an increasing interest and desire for non-invasive tests to assess the stage of liver fibrosis in patients with chronic hepatitis C. There are three main groups of non-invasive methodologies for the assessment of liver fibrosis: serum markers, imaging techniques, and transient elastrography. This review summarizes current information on transient elastography used for non-invasive diagnosis of liver fibrosis in patients with chronic hepatitis C.