Background and study aim: Insulin resistance is typically associated with chronic hepatitis C virus and its improvement after treatment of HCV with new direct antiviral drugs may change portal hemodynamics. This study aimed at assessing changes in HOMA-IR, APRI score and platelet count/spleen diameter ratio as fibrotic markers and changes of portal hemodynamics after treatment with direct- acting antiviral drugs. Patients and Methods: The Study included 100 chronic HCV patients who were eligible for treatment with direct-acting antiviral drugs. HOMA-IR, APRI score and platelet count/ spleen diameter ratio and changes of portal hemodynamics were calculated. Results: The noninvasive indices of liver fibrosis were assessed before and after HCV treatment. Insulin resistance improved significantly after treatment from (3.2±0.9) to (2.9±0.7). Doppler parameters of the studied group also showed marked improvement after treatment where the portal vein flow velocity and flow volume increased (15.8 ±1.7 vs 16.1±1.3) and (728.3±128.2 vs 1059.9±29.6) respectively. Hepatic artery resistive index and calculated congestive index of portal vein also, showed improvement (0.6±0.1 vs 0.49±0.1) (0.077 ±0.014 vs 0.051 ± 0.017) respectively. Conclusion: Direct-acting antiviral drugs may reduce inflammatory and fibrotic sequelae of HCV infection. Also, portal hypertensive indices improved and HOMA-IR, APRI score and platelet count/splenic diameter ratio show improvement.