Quantitative　ultrasound　(QUS)　envelope　statistics　imaging　is　an　emerging　technique　for　the　assessment　of　hepatic　steatosis　in　adults.　Blood　tests　are　currently　recommended　as　the　screening　tool　for　pediatric　hepatic　steatosis,　a　condition　that　can　lead　to　liver　fibrosis　in　children.　This　study　examined　the　utility　of　QUS　envelope　statistics　imaging　in　grading　biomarker-diagnosed　hepatic　steatosis　and　detecting　liver　fibrosis　in　a　pediatric　population.　A　total　of　173　subjects　was　enrolled　(Group　A)　for　QUS　envelope　statistics　imaging　using　two　statistical　distributions,　Nakagami　and　homodyned　K　(HK)　models,　and　information　entropy.　QUS　parameter　values　were　compared　with　the　hepatic　steatosis　index　(HSI)　and　steatosis　grade　(G0:　HSI　＜30;　G1:　30　≤　HSI　＜36;　G2:　36　≤　HSI　＜41.6;　G3:　≥41.6).　An　additional　cohort　of　63　subjects　(Group　B)　was　recruited　to　undergo　both　QUS　envelope　statistics　imaging　and　liver　stiffness　measurements　(LSM)　obtained　from　the　transient　elastography　(Fibroscan),　with　a　cutoff　value　set　at　5　kPa　to　indicate　liver　fibrosis.　The　diagnostic　performances　were　evaluated　using　the　area　under　the　receiver　operating　characteristic　curve　(AUROC).　QUS　envelope　statistics　imaging　generated　the　AUROC　values　for　steatosis　grading　at　levels　≥　G1,　≥　G2,　and　≥　G3　ranged　from　0.94　to　0.97,　0.91　to　0.93,　and　0.83　to　0.87,　respectively,　and　produced　an　AUROC　range　of　between　0.82　and　0.84　for　identifying　liver　fibrosis.　QUS　envelope　statistics　imaging　integrates　the　benefits　of　both　biomarkers　and　elastography,　enabling　the　screening　of　hepatic　steatosis　and　detection　of　liver　fibrosis　in　a　pediatric　population.　©　2023　The　Authors