Changes in liver structure are an important issue in chronic hepatopathies.Until the end of the 20 th century,these changes could only be determined by histological analyses of a liver specimen obtained via biopsy.The well-known limitations of this technique(i.e.,pain,bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases.However,the introduction of non-invasive technologies,such as ultrasound and magnetic resonance imaging,for measurement of liver stiffness as an indirect marker of fibroses has changed this situation.Today,several noninvasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness.This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children,and discusses their features in comparison to the “historical” tools. Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20 th century, These changes could only be determined by histological analyzes of a liver specimen obtained via biopsy. Well-known limitations of this technique (ie, pain , bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases.However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several noninvasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review available the current available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis / cirrhosis with established clinical use in children, and discuss their features in comparison to the “historical” tools.