There is worldwide epidemic of non-alcoholic fatty liver disease (NAFLD). NAFLD 
is a clinical entity related to metabolic syndrome. Majority of the patients are 
obese but the disease can affect non-obese individuals as well. Metabolic 
factors and genetics play important roles in the pathogenesis of this disorder. 
The spectrum of disorders included in NAFLD are benign macrovesicular hepatic 
steatosis, non-alcoholic steatohepatitis, hepatic fibrosis, cirrhosis of liver 
and hepatocellular carcinoma. Although the disease remains asymptomatic most of 
the time, it can slowly progress to end stage liver disease. It will be the most 
common indication of liver transplantation in the future. It is diagnosed by 
abnormal liver chemistry, imaging studies and liver biopsy. As there are risks 
of potential complications during liver biopsy, many patients do not opt for 
liver biopsy. There are some noninvasive scoring systems to find out whether 
patients have advanced hepatic fibrosis. At the present time, there are limited 
treatment options which include lifestyle modification to loose weight, vitamin 
E and thioglitazones. Different therapeutic agents are being investigated for 
optimal management of this entity. There are some studies done on incretin based 
therapies in patients with NAFLD. Other potential agents will be silent 
information regulator protein Sirtuin and antifibrotic monoclonal antibody 
Simtuzumab against lysyl oxidase like molecule 2. But they are still in the 
investigational phase.