Background: Fatty pancreas or nonalcoholic fatty pancreatic disease (NAFPD) is an excessive fat infiltration of the pancreas due to obesity. The need of laboratory marker that can be used as simple non-invasive biomarker to aid in diagnosis is crucial to be adding to the investigations, especially when used the abdominal ultrasound. Fatty acid binding protein 1 (FABP1) is a tissue specific marker that can be used to diagnose NAFPD as per Nature. Objective: To determine the incidence of NAFPD among obese and non-obese Egyptian people with or without DM, evaluate for possible association with DM or obesity, correlate between pancreatic steatosis (NAFPD) and non-alcoholic liver disease, and evaluate the diagnostic role of FABP1 in Egyptian patient with or without DM in relation to obesity. Patients and methods: A prospective cohort study included 80 patients aged from 18-70 years, attended the outpatient clinic of the Liver and Digestive System and Infectious Diseases Department at Al-Azhar University Hospital (Cairo) from January 2020 to December 2020. Patients were a divided into 4 equal groups: Group 1: Apparently healthy individuals with normal BMI and non-diabetic, Group 2: Patients with normal BMI, diabetics or impaired fasting blood glucose, Group 3: Patients with BMI over 25 non-diabetics, and Group 4: Patients with BMI over 25, diabetics or impaired fasting blood glucose level. Results: There was a significant statistically difference between groups as regard to FABP1. The results of this study showed that the level of FABP1 was significantly higher in grade I, II and III more than grade 0 of pancreatic echogenicity. On the other hand, the level of FABP1 showed a significant increase in grade III liver echogenicity more than grade I and II. Also, grade I, II and III showed a significant increase in FABP 1 more than grade I liver echogenicity. By using FABP 1 as a predictor to pancreatic echogenicity, it was found that at cut off value 32.0, the sensitivity of FABP1 to diagnose pancreatic echogenicity was 86.0%, specificity was 80.0%, and total accuracy was 84.0%. By using FABP1 as a diagnostic marker in liver echogenicity at cut off value 31.0, the sensitivity was 81.0%, specificity was 76.0% and total accuracy was 78.0%. Conclusion: FABP1 can be used a diagnostic biomarker for non-alcoholic fatty pancreatic disease.