Objective: The aim of the present study was to determine the relationship between serum levels of biochemical parameters and histological evaluation of liver biopsy specimens in patients with chronic hepatitis B infection. Material and Methods: This retrospective study was carried out in 21 female and 55 male patients and the mean age was 38 +/- 10 years. Liver biopsy was obtained from patients with HBV DNA > 105 copies/mL (for HBeAg positive patients) or 104 copies/mL (for HBeAg negative patients) for histological analysis and 24 patients with stage parameters 2 were included in group I and 52 cases with >= 2 in group II. The patients were grouped according to the scoring system for chronic hepatitis modified from Scheuer. Results: The HBV DNA levels were 834183 +/- 16821275 copies/mL in group I and 93072001 +/- 348168594 copies/mL in group II (p = 0.241). The mean level of the serum liver enzyme ALT in patients with stage >= 2 in group II (153.36 +/- 227.63 U/L) was statistically higher than the mean ALT level of patients with grade less than 2 in group I (46.58 +/- 31.59 U/L) (p = 0.025). While the higher total protein and albumin/globulin ratio in group I was statistically significant (p = 0.005; p = 0.004), the difference in serum albumin levels was not (p = 0.839). The mean alpha-fetoprotein level (3.13 +/- 1.76 IU/mL) of group I patients was less than the level in group II (3.63 +/- 3.73 IU/mL); this difference was not statistically significant (p = 0.531). There was also no statistically significant difference in blood platelet counts between group I and II (214041 +/- 52410.98 K/uL and 212846 +/- 54743.03 K/uL respectively; (p = 0.928)). The international normalized ratio (INR) of patients in group I was 13.4 +/- 0.67 and 13.31 +/- 0.70 in group 11; this difference was not statistically significant (p = 0.623). Conclusion: There appears to be an association between serum levels of ALT and albumin/globulin ratio and the extent of hepatic fibrosis in patients with chronic HBV infection. Currently available non-invasive markers of disease activity do not seem to be good predictors for disease progression.