ABSTRACT Background: Non-alcoholic fatty liver disease (NAFLD) is a risk factor for increased morbidity and mortality plus cardiovascular disease and malignancy. Despite all of these, most patients have good prognosis if diagnosed at early stages. Objective: The study was designed to evaluate different non-invasive methods as a diagnostic tool of non-alcoholic fatty liver disease among diabetic and non-diabetic patients. Patients and Methods: The study was done on 100 patients were divided into two groups of 50 diabetics and 50 non-diabetics with fatty liver disease on abdominal ultrasonography finding. These patients were assessed with transient elastography (TE) after lab tests and then scoring systems (Fib-4 and NAFLD fibrosis score) and liver stiffness scores were compared between the two groups. Results: There was statistically significant difference between the two groups as regard Fib-4 and NAFLD fibrosis score (p < 0.001), where Fib-4 and NAFLD fibrosis score were higher in group I (diabetic) than in group II (non-diabetic). A statistically significant difference between the two groups as regard liver stiffness (p < 0.001), where liver stiffness was higher in group I than in group II. Liver stiffness score and NAFLD fibrosis score were statistically significantly higher in those with (>F2) than those with (F2 or less) (p < 0.001). Conclusion: A combination of Fibroscan, Fib-4 and NAFLD fibrosis score provides a valuable non-invasive method in diagnosis of NAFLD patients, and this can eliminate the need for liver biopsy in patients without clear indication, especially diabetic patients that can help in early diagnosis of NAFLD before development of fibrosis.