To investigate hepatosplenic volumetry at MDCT for non-invasive prediction of hepatic fibrosis. Hepatosplenic volume analysis in 624 patients (mean age, 48.8years; 311M/313F) at MDCT was performed using dedicated software and compared against pathological fibrosis stage (F0 = 374; F1 = 48; F2 = 40; F3 = 65; F4 = 97). The liver segmental volume ratio (LSVR) was defined by Couinaud segments I-III over segments IV-VIII. All pre-cirrhotic fibrosis stages (METAVIR F1-F3) were based on liver biopsy within 1year of MDCT. LSVR and total splenic volumes increased with stage of fibrosis, with mean(±SD) values of: F0: 0.26 ± 0.06 and 215.1 ± 88.5mm3; F1: 0.25 ± 0.08 and 294.8 ± 153.4mm3; F2: 0.331 ± 0.12 and 291.6 ± 197.1mm3; F3: 0.39 ± 0.15 and 509.6 ± 402.6mm3; F4: 0.56 ± 0.30 and 790.7 ± 450.3mm3, respectively. Total hepatic volumes showed poor discrimination (F0: 1674 ± 320mm3; F4: 1631 ± 691mm3). For discriminating advanced fibrosis (≥F3), the ROC AUC values for LSVR, total liver volume, splenic volume and LSVR/spleen combined were 0.863, 0.506, 0.890 and 0.947, respectively. Relative changes in segmental liver volumes and total splenic volume allow for non-invasive staging of hepatic fibrosis, whereas total liver volume is a poor predictor. Unlike liver biopsy or elastography, these CT volumetric biomarkers can be obtained retrospectively on routine scans obtained for other indications. • Regional changes in hepatic volume (LSVR) correlate well with degree of fibrosis. • Total liver volume is a very poor predictor of underlying fibrosis. • Total splenic volume is associated with the degree of hepatic fibrosis. • Hepatosplenic volume assessment is comparable to elastography for staging fibrosis. • Unlike elastography, volumetric analysis can be performed retrospectively.