Background: Helicobacter pylori (H. Pylori) infection has been notified to enhance the progression of distinct extra-digestive manifestations, embraced type 2 diabetes, liver, and cardiovascular diseases. Currently, the association between H. pylori infection and nonalcoholic fatty liver disease (NAFLD) was suggested. Conversely, evidence from various studies was doubtful. Aim of the study: This study was performed to assess the prevalence of H. Pylori infection and the possible predictors of H. Pylori infection among NAFLD patients. Patients and Methods: This prospective observational case-control study included a total of 60 patients with NAFLD and 20 apparently healthy subjects served as control, attending at the Outpatient Clinic and Internal Medicine Department, Sayed Galal; Al-Azhar University Hospitals. This study was conducted between February 2018 to March 2019. All participants were submitted to full history taking, complete physical examination, and routine laboratory investigations. H. pylori Ag in stool test was tested to reveal the existence of infection along with abdominal ultrasonography using Hamaguchi scoring system for assessment of NAFLD. Results: An overall 80 participants were included in the current investigation. Based on the presence of NAFLD, participants were assorted into healthy control group (20 candidates) and NAFLD group (60 patients) with a mean age of 35.65±10.73 and 39.72±11.14, respectively. An overall 48 patients were infected with H. Pylori. Of them, 6 (30%) were among the healthy control group, whereby 42 (70%) were among NAFLD group (P<0.001). Based on the multivariate logistic regression model, the male gender and the levels of high density lipo-proteins (HDL-C) were statistically significant predictors of H. Pylori infection among NAFLD patients. Conclusions: The burden of H. Pylori infection among NAFLD patients was noticeably high. Additionally, obese males with decreased levels of HDL-C were more expected to be H. Pylori positive infection.