Necroinflammation is a hallmark feature in several causes of chronic liver disease. Because it has multiple tissue contrast mechanisms, MRI is ideally suited for characterization of histopathological changes (i.e. inflammation, fat, iron, and fibrosis) that may occur concomitantly in chronic liver disease. We evaluated intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) MRI for assessment of necroinflammation. Perfusion fractions were significantly correlated with necroinflammation grades (ρ = 0.49, P < 0.0001) and could discriminate grades ≤ A1 vs. ≥ A2 and ≤ A2 vs. A3 with good accuracy (AUC: 0.81 and 0.80, respectively). Our results suggest that perfusion fraction may be used for assessing liver necroinflammation.