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Introduction: Liver stiffness measurement (LSM) is a widely used non-invasive test to assess the stage of liver fibrosis in chronic liver diseases, particularly in HCV but its clinical usefulness after viral elimination is uncertain. Objectives: To identify the course of liver fibrosis by LSM 3 years after viral elimination in patients with HCV and its association with clinically relevant outcomes: progression to advanced liver fibrosis/cirrhosis (≥F3) in those with F<3 at baseline, and decompensation (ascites, variceal hemorrhage, encephalopathy) or HCC in those with F3/F4 or F4 at baseline. Methods: LSM were performed by Fibroscan in 228 patients (32 stage F0-1; 47 F2; 36 F3; 23 F3-4; 90 F4 as determined by LS of <7.1; 7.2-9.5; 9.6-12.5; 12.6-14.5 and >14.5 KPa respectively) prior to treatment and at 6 months, 1, 2 and 3 years after cure. Results: The course of changes in LSM are depicted in figure1. There was no progression to F≥3 in any of the patients at stages F0-1, F2. Among patients with F≥3, 23 patients developed decompensation (1 F3, 2 F3/F4 and 20 F4) and 9 developed HCC (all F4). Probability of decompensation is lower in patients in whom LSM decreases at 6 months, while it is higher in those in whom LSM increases, however CI are large (Table). Conclusion: While in patients with F0-1, F2 prior to antiviral therapy, there is no need to follow LSM as progression does not occur, LSM should be continued in those with F3/F4 or F4 (>12.5 kPa). Changes in LSM at 6 months can help determine probability of outcomes but larger studies combining other parameters are necessary to improve predictive value.