In recent years, in the pathogenesis of metabolic syndrome (MS), great importance has been attached to non-alcoholic fatty liver disease (NAFLD) and violation of the intestinal microbial-tissue complex. This review summarizes current data on possible pathophysiological mechanisms that link NAFLD, pregnancy, and intestinal microbiota disorders. The clinical consequences of NAFLD influence on pregnancy and development of obstetric complications and adverse perinatal outcomes are analyzed.