Objective: To investigate the evaluation value of sound touch elastography (STE) combined with aspartate aminotransferase (AST)-to-platelet ratio index (APRI) on liver fibrosis in patients with chronic hepatitis B (CHB). Methods: A total of 96 CHB patients admitted to Second Affiliated Hospital of Hainan Medical College from January 2019 to August 2021 were selected. All patients completed STE examination (elastic modulus value), and the determination of biochemical indexes of liver function [including AST and platelet count (PLT)], then calculated APRI. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of each index on liver fibrosis with the results of liver histopathology as the gold standard. Results: With the aggravation of liver fibrosis, the elastic modulus and serum APRI of patients gradually increased, and the difference was statistically significant (P<0.05). Spearman correlation analysis showed that the elastic modulus was positively correlated with the pathological stage of liver fiber (r=0.589, P<0.001), and APRI was also positively correlated with the pathological stage of liver fiber (r=0.410, P<0.001). The area under the curve (AUC) of STE elastic modulus in the diagnosis of liver fibrosis ≥S2, ≥S3, and S4 were 0.852, 0.954, and 0.959, respectively. The AUC of APRI were 0.887, 0.928, and 0.935, respectively. The AUC of combined diagnosis were 0.918, 0.974, and 0.984. Conclusion: STE and serum APRI have high evaluation value for liver fibrosis in CHB patients, and the combination of the two can improve the diagnostic efficacy.