Background: In Egypt, irritable bowel syndrome (IBS) and non-alcoholic fatty liver disease (NAFLD) are both common conditions. There has been increased interest in the apparent co-incidence of NAFLD in individuals with IBS as we gain a better understanding of their overlapping risk factors and pathophysiology. The aim: to ascertain the prevalence of NAFLD among IBS patients, as well as the relationship between NAFLD and IBS severity. Patients and methods: A cross-sectional study was conducted on 150 IBS patients who were older than 18 years old at the Hepatology, Gastroenterology, Infectious Diseases Outpatient Clinic and Clinical Pathology Department of Al-Ahrar Zagazig Teaching Hospital. All patients underwent a history taking, general clinical examination, and clinical assessment, imaging studies and laboratory analysis. Results: There were 70.7% people who had NAFLD. 30.2% of patients had severe NAFLD, 19.8% had mild NAFLD, and 50% of patients had intermediate NAFLD. Conclusion: IBS patients have a significant prevalence of NAFLD. In the study participants, moderate/severe NAFLD was a predictor of moderate/severe IBS.