Background: Non-alcoholic fatty liver disease (NAFLD) is a heterogeneous condition that contains steatosis and non-alcoholic steatohepatitis (NASH), in the nonexistence of significant alcohol consumption, reaching 30% of the populace. The most common risk features are: age, ethnicity, gender, obesity, drugs, diabetes mellitus (DM), insulin resistance (IR), predisposition, metabolic syndrome (MS), and polycystic ovary syndrome. Materials and Methods: Patients with non-alcoholic fatty liver disease were evaluated, with medical and epidemiological data collected after informed consent at King Abdulaziz Hospital. Results: Of the 124 patients evaluated, 75.8% were women, and 88 were aged between 49 and 70 years and had no symptoms. Ultrasonography results showed steatosis in 84%. NASH was diagnosed in 75 patients of the sample. 42 patients underwent liver biopsy, of which 36% had cirrhosis, 1 had liver cancer, and 1 pure steatosis (5% each). Risk factors were found in 70% of patients with metabolic syndrome, 87% with increased waist circumference, 63% with dyslipidemia, 61% (n=76) with high blood pressure (HBP), 28% with DM, 52% physically inactive, and 44% with insulin resistance (IR) (HOMA> 3.5). There was an association between IR and NASH (p=0.011), IR and obesity (p=0.031), IR and MS (p=0.007), and MS and steatosis on medical ultrasound (USG) (p=0.012). Conclusion:  The results indicated that the most frequent risk factors were MS and its variables: increased waist circumference, dyslipidemia and HBP. This highlights the significance of metabolic control in non-alcoholic fatty liver disease and confirms its role as the hepatic component of metabolic syndrome.