Background: Non-alcoholic fatty liver disease (NA FLD) represents a major public health challenge in patients with type 2 diabetes mellitus (T2D). It may progress to non-alcoholic steatohepatitis (NASH), cirrhosis, and carcinoma. Our aim was to detect the changes of the fatty liver index (FLI) and FIB-4 score six months after treatment with liraglutide, or dulaglutide; novel antidiabetic medi-cations in the Egyptian market versus the conve-ntional therapy in Egyptian patients with T2D and co-existent NAFLD. Methods: A non-concurrent retrospective cohort study conducted at the outp-atient department of authors´ institution (Mansoura University hospitals) during the period from October 2019 to March 2020, included three matched groups of patients composed of Egyptian patients with T2D with age range from 35-65 years old, HbA1c level above 7.5%, body mass index (BMI) above 25 kg/m2, estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and with concomitant NAFLD (diagnosed with hepatic ultrasonography and fatty liver index >30). Clinical history, examination with anthropometric measures, CBC, HBA1c, serum lipid, ALT, AST, GGT, serum creatinine and thyroid profile were measured before and after 24 weeks of treatment. The fatty liver index (FLI) and the FIB-4 score were used to assess hepatic steatosis and fibrosis respectively. Results: There was a significant improvement of the FIB-4 and FLI values in the patients who used liraglutide and dulaglutide compared to the conventional treatment and with better results in the liraglutide group. Moreover, there was a significant reduction of the body weight, waist circumference, BMI, SBP, DBP, GGT, ALT, AST, HBA1c, triglyceride, total cholesterol, LDL-C and VLDL-C values in the liraglutide and dulag-lutide groups versus the conventional treatment group. FLI, AST and platelet count changes were the significant predictors of the change in log FIB-4 score. However the change in log FLI was independently affected by ALT changes. Conclusion: the addition of the liraglutide or dulaglutide exhibited many clinical and metabolic beneficial effects in the patients with concomitant T2D and NAFLD.