Background/Aims: Liver biosy is usually used to assess the expect of hepatic fibrosis, however, it is limited hecause serious complications have been reperted accasionally and frequent examinations are not adequate, Recently, the serum level of type IV collagen-7S domain is known to reflect the activity of collagen synthesis in the process of fibrosis. We evaluate the clinical usefulness of serum type IV collagen as an indicator of hepatic fibrosis. Methods: Serurn levels of type IV collagen 7S domain were evaluated in 88 subjects including 20 healthy persons, 40 patients with chronic active hepatitis confirmed by liver biopsy and 28 patients with liver cirrhosis. The patients with chronic active hepatitis were classified as mild(18 cases), moderate(11 cases) and severe degree(11 cases) according to the histologic findings and the patients with liver cirrhosis were classified as Child A(10 cases), B(10 cases), C(8 cases) according to modified Childs classification. Serum level of type IV collagen-7S domain was measured by radioimmunoassay (RJA). Results: Serum type IV collagen-7S domain concentrations in patients with chronic active hepatitis and liver cirrhosis were significantly higher than those in healthy persons(p<0.05). And significant correlations between the patients with chronic active hepatitis and with liver cirrhosis were also found(p<0.05). When chronic active hepatitis was divided into mild, moderate and severe degree there was a statistical significances(p<0.05). And significant correlations were found between the serum type IV collagen and the grade of the modified Childs classification(p<0.05). Conclusions: These results suggest that the measurement of serum type IV co]lagen may be a simple, noninvasive method and sensitive rnarker of hepatic fibrosis and also may reflect tbe status of progression in cirrhosis. (Korean J Gastroenterol 1997; 29:65 - 73)