Background: The prevalence of NAFLD (non- alcoholic fatty liver disease) is increasing as it exceed (31.79%) in Middle East and the metabolic syndrome prevalence in patients with NAFLD ranges from 18% to 67%, according to the body weight. Imaging or histology is very important tools in diagnosis of NAFLD. Early detection of NAFLD is very important especially if there is a non-invasive method. The clinicians in the primary, secondary and tertiary care are in need for specific and sensitive diagnostic tool that can be used easily. Aim: To study and analyze serum lipid changes in non-alcoholic fatty liver disease of different grades. Patients and methods: 100 patients diagnosed by ultrasonography as NAFLD, whose age was more than 18 years, were included in the study. History taking, full clinical examination and anthropometric measurement of weight, height and body mass index (BMI) were done for all patients. Serum lipid profiles including total cholesterol, HDL, LDL, triglycerides, ALT, AST. CBC, fasting and 2hpp blood glucose and TSH were measured. Results: The largest group of patients (38%) was in the fifth decade of life. followed by 30% in the sixth decade of life. As the grade of NAFLD increased, there was associated significant increase in levels of serum total cholesterol (P-value 0.005), TG (P-value 0.002) LDL (P-value 0.001) and VLDL (P-value 0.003) and associated significant decrease in HDL (P-value 0.001). Conclusions: abdominal ultrasonography and increased lipid profile values can be used to detect NAFLD early