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Background: No previous study have evaluated transient elastography (TE) for predicting esophageal varices (EV) in hepatosplenic schistosomiasis (HSS). Aim: To investigate noninvasive methods of predicting EV in patients with HSS mansoni. Methods: Cross-sectional multicentric study included 51 patients with HSS. Patients underwent ultrasonography-dopplerfluxometry, upper endoscopy, complete blood cell count and TE (Fibroscan®) for liver and spleen stiffness measurement (LSM and SSM). Noninvasive scores previously established for cirrhotic population were studied: platelet count to spleen diameter ratio (PSR), LSM-spleen diameter to platelet ratio score (LSPS) and varices risk score (VRS). We proposed a version of LSPS and VRS by replacing LSM with SSM and named them SSPS and modified-VRS, respectively. Results: EV was detected in 42 (82.4%) subjects. Individuals with EV presented higher SSM (73.5 vs 36.3 Kpa, p=0.001), splenic vein diameter (10.8 vs 8.0 mm, p=0.017), SSPS (18.7 vs 6.7, p=0.003) and modified-VRS (4.0 vs 1.4, p=0.013), besides lower PSR (332 vs 542, p=0.038), than those without EV. SSPS was independently associated with EV presence (OR=1.19, 95%CI 1.03-1.37, p=0.020) after multivariate analysis. In a model excluding noninvasive scores, SSM was independently associated with EV diagnosis (OR=1.09, 95%CI 1.03-1.16, p=0.004). AUROC was 0.856 (95%CI 0.752-0.961, p=0.001) for SSM and 0.816 (95%CI 0.699-0.932, p=0.003) for SSPS (p=0.551). Conclusions: Spleen-related variables were predictors of EV: SSM, splenic vein diameter, SSPS, modified-VRS and PSR. Multivariate models indicated that SSM and SSPS are useful tools for predicting EV in non-cirrhotic portal hypertension by HSS and may be used in clinical practice.