Abstract Background: Coronary Artery Disease (CAD) is consid-ered to be a leading cause of morbidity and mortality world-wide, so early detection of CAD in asymptomatic individuals is required. Several metabolic risk factors contribute to development of both Non-alcoholic Fatty Liver Disease (NAFLD) and CAD. Aim of Study: To evaluate the presence and the severity of Coronary Artery Disease (CAD) among Non-alcoholic Fatty liver Diseases (NAFLD) patients compared to non-fatty liver population and to evaluate the association of NAFLD and CAD using MSCT and subsequently the possibility of considering NAFLD as a predictor for CAD. Patients and Methods: The study was conducted in Radi-ological Department of Ain Shams Hospital. It focused on evaluating 42 patients, who were referred to perform CT coronary angiography. These patients were examined in the period between from December 2015 till December 2016. The target sample was patients with non-alcoholic fatty liver who underwent CT coronary angiography for recent chest pain. Fatty liver was diagnosed using non-contrast CT when calculated attenuation value of the liver is less than spleen by 10 UH. The coronary arteries were assessed using CT angiography, significant CAD was defined as a stenosis of more than 50% in at least one major coronary artery. Results: Non-alcoholic fatty liver patients developed coronary atherosclerosis were 16 (76.2%) and this was statis-tically significant p=0.028. Conclusion: Non-alcoholic Fatty liver disease may be considered as a predictor for coronary atherosclerosis and based on this; more individuals from the general population with subclinical CAD could be detected at earlier stages when fatty liver is identified. Presence of non-alcoholic fatty liver may help in cardiovascular risk stratification and assessment.