Background and aim of work: metabolic hepatosteatosis is a common serious prevalent condition in KSA. The current study investigated alpha lipoic acid (ALA) effects on hepatic lipid accumulation in severely fatty rats and secondarily on blood lipid profile.
 Materials and methods: sixty male Zucker rats were selectively used half of which (Lean) weighed 200±25g & others weighed 375±30g. Fatty animals were allowed free access to food and water for one week before experiment. The animals were divided into lean untreated (group I), lean ALA – managed (group II), fatty untreated (group III) and fatty ALA – managed (group IV) (fifteen animals per each group). ALA was taken orally (20 mg/kg/day) for six months. Animals were sacrificed and weighed (BW). Their liver was weighed (LW) and its portion was sliced to study its lipid content. Right tibia length (TL) was measured and LW: TL ratio was calculated.
Results: ZF ALA-untreated rats showed high LW: TL ratio. ALA therapy significantly reduced BW, TL, LW and LW: TL ratio in managed ZF rats compared to untreated ones while it didn't affect these parameters significantly in lean (ZL) rats. ZF rats exhibited significant hepatosteatosis evidenced by excessive liver triglyceride (TG) and total cholesterol (TC) contents and microscopically by large cytoplasmic vacuoles. Interestingly, 6-months' ALA therapy in ZF caused significantly diminished serum triglycerides and cholesterol levels as well as  diminished hepatic triglycerides and TC component in addition to decreased its lipid vacuoles compared to untreated ZF rats. The results were insignificantly changed between managed and untreated lean groups.
 Conclusion: our findings support effectiveness of ALA therapy in excessive hepatosteatosis and in hyperlipidemia via improving abnormal lipid metabolism.