Fatty liver is excessive accumulation of lipid in hepatocytes. Non-alcoholic fatty liver disease (NAFLD) includes simple fatty infiltration (a benign condition called fatty liver), whereas non-alcoholic steatohepatitis (NASH) is defined as the presence of fat leading to lipotoxicity and inflammatory damage to hepatocytes (Liver Cells). Histologically, NASH is difficult to distinguish from alcoholic hepatitis. Thus, to diagnosis NASH, underlying alcohol use must be ruled out. Differentiating simple Fatty Liver (Steatosis) from NASH can be difficult without a liver biopsy, and elevated liver enzymes are not a sensitive predictor for identifying NASH. The presence of metabolic syndrome (obesity, dyslipidaemia, hypertension, and glucose intolerance) increases the likelihood that a patient has NASH rather than simple steatosis. Most patients do not exhibit symptoms. Although non-invasive diagnostic tests are usually sufficient, liver biopsy remains the gold standard