Backgroundː Non-alcoholic fatty liver disease (NAFLD) incorporates a wide spectrum of stages ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis, and hepatocellular carcinoma (HCC). The connection of Long noncoding RNAs with NAFLD, as well as other metabolic syndromes remains relatively unexplored. Objective: We aimed to investigate the circulatory level of lncRNA-PVT1 in patients with Non-alcoholic fatty liver disease complicated with steatohepatitis, cirrhosis, and HCC. Also, to explore their association with different clinical and laboratory variables. Patients and methodsːA case-control study enrolled 100 patients with NAFLD and 100 healthy volunteers. NAFLD patients included 53 patients with simple steatosis, 22 steatohepatitis patients, 17 cirrhotic patients, and 8 HCC patientsconfirmed with histopathological examination. The expression of lncRNA PVT1 was evaluated by RT PCR. ResultsːThe relative expression levels of lncRNA-PVT1 were significantly higher in the NAFLD group (2.29±0.37) compared to control (0.84±0.52), P˂0.001 with a significant difference between the subgroups; (4.2 ± 0.1, 2.9 ± 0.16, 1.93 ± 0.14, 1.25 ± 0.18 in HCC, cirrhosis, NASH, and in simple steatosis respectively; P˂0.001). There were significant direct correlations with liver function tests, lipid profile, and alpha-fetoprotein in the HCC subgroup. Alpha-fetoprotein and AST were the main predictors of lncRNA-PVT1. Cut-off values 0.94, 1.2, 1.8, 2.98 were able to discriminate simple steatosis, steatohepatitis, cirrhosis, and HCC with AUC 0.78, 0.64, 0.77, 0.81 respectively. Conclusionsː Circulating lncRNA-PVT1 could be a useful diagnostic biomarker for discriminating patients with advanced NAFLD stages.