PURPOSE: To evaluate changes of the waveform of the hepatic vein on Doppler ultrasound (US) in patients with chronic hepatitis B and to correlate them with histologic findings. MATERIALS and METHODS: Thirty three patients with chronic hepatitis B were prospectively examined with Doppler US, and liver biopsy was done at the same time. The right hepatic vein was examined on Doppler US, and a liver biopsy was performed in the right lobe of the liver. Doppler waveform was considered abnormal if it showed either reduction in the amplitude of phasic oscillation without the reversed flow phase or the presence of completely flat flow. Specimens obtained from the biopsy were classified according to the predetermined histologic scoring criteria. RESULTS: It was technically possible to perform Doppler US of the right hepatic vein and liver biopsy simultaneously in all thirty three patients. Waveforms of the right hepatic vein were abnormal in fourteen (42.4%), biphasic in 12 (36.4%) and flat in two (6.0%) patients. Only the steatosis(terminology) exhibited statistically significant correlation between changes of doppler waveform (p<0.05) of the normal and abnormal groups. CONCLUSION: Doppler US patterns of the hepatic vein in chronic hepatitis B were different from those of the normal group. The abnormal flow pattern on hepatic venous doppler appeared to be mainly influenced by the intrahepatic fat deposition rather than the degree of fibrosis.