BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a clinico-pathological entity, increasingly recognised as a major health burden in developed countries and the fastest rising form of chronic liver disease worldwide. It is gaining concern among physicians in developing countries as well as it is predicted that its prevalence may surpass that of chronic hepatitis. It includes a spectrum of liver damage ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), advanced fibrosis and rarely progression to cirrhosis. MATERIALS AND METHODS This was a descriptive study conducted in Department of Medicine, SSMC and SGMH, Rewa. A total of 200 cases were included in the study, who were diagnosed as having fatty liver on the basis of ultrasonography (USG) during the study period of April 2016 to July 2017 and were further investigated for metabolic syndrome. RESULTS Out of 200 cases, 55.5%, 36% and 8.5% of cases had grade I, II and III fatty liver respectively. 128 (64%) had metabolic syndrome. 63.93%, 61.11% and 76.84% of grade I, II and III NAFLD patients suffered from metabolic syndrome respectively. All the components of metabolic syndrome were significantly associated with NAFLD (p ≤ 0.05).