Vutien P, Kim NJ, Moon AM, et al. - As anti‐viral treatment for hepatitis C virus (HCV) infection results in reduction of fibroscan‐derived liver stiffness, researchers here examined if liver stiffness pre‐ or post‐anti‐viral therapy is linked with the development of decompensated cirrhosis, hepatocellular carcinoma (HCC) or death. They conducted a retrospective cohort study of US veterans who began HCV treatment and had at least one liver stiffness before (n = 492) or after (n = 877) HCV therapy. In the posttreatment liver stiffness cohort, decompensated cirrhosis developed in 21 patients (2.4%), HCC developed in 26 patients (3.0%) and death or liver transplantation was reported in 57 patients (6.5%) during a mean follow‐up of 27.3 months. Observations revealed independent correlation of posttreatment liver stiffness > 20 kPa, but not of pretreatment liver stiffness, with the development of decompensated cirrhosis and the composite outcome in multivariable analyses. They emphasize that liver stiffness should be measured after anti‐viral treatment as it prognosticates adverse outcomes even beyond routinely available clinical predictors.