Liver attenuation was investigated in comparison to the well-established liver stiffness for detecting hepatic fibrosis in 108 patients with histology-proven chronic liver diseases. Both liver stiffness and attenuation successfully detected varying fibrosis and inflammation with equivalent accuracy. At 40 and 60Hz, both have excellent accuracy for distinguishing clinical significant fibrosis or inflammation from others; moderate accuracy were obtained in distinguishing mild abnormalities from patients without abnormalities. Steatosis extent had no significant effect on liver stiffness and attenuation measurements. Our findings indicate that shear attenuation has equivalent diagnostic performance to that of liver stiffness for detecting liver disease progression.