BACKGROUND: Nonalcoholic fatty liver disease is an increasingly recognized condition that may progress to end-stage liver disease. These patients are at higher risk of developing cirrhosis, terminal liverfailure and hepatocellular carcinoma. OBJECTIVES: To study the presence of NASH in high risk group of patients and their correlation with NASH. METHODS: 200 high risk non-alcoholic patients were selected from indoor patients and out patient department of Medicine, Guru Nanak Dev Hospital attached to Government Medical College, Amritsar during the year 2011-12. A diagnosis of NASH was made on the basis of symptoms and signs, supplemented with analysis of liver enzymes, ultrasonography abdomen. Liver biopsy was not done because all patients refused to give consent for it. Fatty liver on USG with raised AST and ALT were labelled as having NASH. FBS and lipid profile estimation, hepatitis B surface antigen and antibodies to hepatitis C virus were done in all of them. RESULTS: The prevalence of NASH was found to be 22% (44 out of 200 patients) by ultrasonography with raised AST and ALT levels. It was significantly higher in patients with diabetes mellitus, dyslipidemia, central obesity, hypertension, females and in age group 46 - 60 years with their additive effect to each other. CONCLUSION: The present study identifies the people at higher risk of developing NASH and offer future perspective to develop preventive strategy in them. JMS 2012;15(2):157-61