Background: Regarding the growing prevalence of non-alcoholic fatty liver disease, concentrating on various strategies for its prevention and management seems necessary.Objectives: This study aimed to assess the effects of synbiotic administration on body composition and lipid profile in patients with NAFLD.Methods: Eighty patients with NAFLD participated in this randomized, double-blind, placebo-controlled clinical trial (from March to July 2014) in Iran. Based on AST and ALT as main variables of the study, 34 patients were required in each group (power 80% and α = 5%). Considering a 20% sample loss, 80 patients were enrolled. Synbiotic supplement in form of a 500 mg capsule (containing 7 species of probiotic bacteria and Fructooligosaccharides) was administrated to patients in the intervention group and those in the placebo group received 1 placebo capsule daily for 8 weeks. At the baseline and the end of the study, body composition and lipid profile were evaluated.Results: A significant reduction was observed in weight (P = 0.001), body fat (P = 0.02), and total cholesterol (P = 0.04) within the synbiotic group. On the other hand, WC (P = 0.02), total cholesterol, and LDL-c (P = 0.04 and P = 0.001, respectively) were significantly increased in the placebo group. TG, HDL-c, and FBG levels remained statistically unchanged in both groups. Significance betweengroup differences were seen in total cholesterol (P = 0.01), LDL (P = 0.01), weight, WC, and body fat after adjustment for energy intake (P = 0.05).Conclusions: Synbiotic supplementation may improve lipid profile and body composition in patients with NAFLD and might be useful in prevention of the disease progression.