Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver or in the case of S. haematobium, the bladder. Various methods are utilized to diagnose and evaluate liver fibrosis due to schistosomiasis. Liver biopsy is still considered the gold standard but it is invasive. Diagnostic imaging has proven to be an invaluable method in assessing hepatic morbidity in the hospital setting but has practical limitations in the field. The potential of non-invasive biologic markers, serum antibodies, cytokines and circulating host microRNAs to diagnose hepatic fibrosis are-presently undergoing evaluation and are discussed.