Background:In Nonalcoholic fatty liver disease (NAFLD), histopathological differentiating from simple steatosis to nonalcoholic steatohepatitis (NASH) can only be confirmed by liver biopsy. These is new promising non invasive marker , Plasma pentraxin (PTX3) to discriminate NASH from non-NASH patients, and it is related to degree of liver fibrosis in NASH patients.Objectives: our aim is to investigate the clinical usefulness of plasma Pentraxin3 (PTX3) levels versus fibroscan to predict NASH and the potential relationship of its levels with the degree of liver damage in NAFLD /NASH Egyptian patients Methods: Plasma PTX3 levels & traniset elastogrophy (fibroscan) measurements were estimated in 60 Eqyptain patients with NAFLD (30 with NASH, 30 with non-NASH) and 20 healthy controls.Results: PTX3 levels were found significantly higher in the NAFLD group than in the control group (P < 0.001), and in NASH subgroup than non-NASH subgroup (P=0.001). To discriminate NASH from non-NASH, PTX3 had 96.67% sensitivity and 93.33% specificity at the cutoff value of 3.1ng/ml. Plasma PTX3 levels showed no significant correlation with NAFLD activity score, fibrosis stage and steatosis. Conclusion:This study demonstrated markedly higher PTX3 levels in NAFLD patients compared with controls, and in NASH patients compared with non-NASH ones and no correlation with fibroscan stages. Thus, in this cohort we showed that plasma PTX3 may be a promising biomarker for the presence of NASH.