The fatty change and the inflammation spectrum are similar to the alcoholic fatty liver disease. While primary or idiopathic NAFLD forms the major part of this disease spectrum, we should always address secondary causes leading to fatty changes in liver. Management consists of general measures of risk reduction like: instituting weight loss program, diet control, exercise, weight loss drugs, use of insulin sensitizers like metformin and thiozolidinediones, use of cytoprotective agents like vitamin E, betaine and hypolipidemics like statins