Background: Metabolic associated fatty liver disease (MAFLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a condition characterized by the accumulation of fat in the liver, which can lead to inflammation, scarring, and liver damage. This study aimed to assess serum nesfatin-1 levels in patients diagnosed with MAFLD. Patients and Methods: This case-control study included 76 participants, implemented at Gastroenterology and Hepatology Unit, and Outpatient Clinic of Internal Medicine Department of Benha University Hospital during the period from April to September 2023. They were divided into two equal groups: Group I: included 38 patients with MAFLD, while group II: included 38 apparently healthy age and sex matched individuals as a control group. Results: Serum nesfatin-1 showed a significant negative correlation with alanine aminotransferase (ALT), and it showed a significant negative correlation with high sensitivity-C reactive protein (hs-CRP) and fasting insulin level in the MAFLD group. Logistic regression analysis was conducted for prediction of MAFLD revealing that aspartate aminotransferase (AST), ALT, γ-glutamyl transferase (GGT), hs-CRP, high density lipoprotein (HDL), low density lipoprotein (LDL), fasting insulin, homeostatic model assessment insulin resistance (HOMA-IR) and nesfatin-1were all associated with the risk of MAFLD in univariate analysis. A receiver operating characteristic (ROC) curve of nesfatin-1 was conducted for prediction of MAFLD, and it showed moderate accuracy with an area under curve (AUC)=0.776 at best cut-off value of 0.270, with 86.8% sensitivity and 84.2% specificity. Conclusion:Nesfatin-1 may be a potential biomarker for the diagnosis of MAFLD.