Background: MAFLD is prevalent throughout the world, with estimated prevalence 25%. Although advanced liver fibrosis has been shown to have a significant impact on the incidence and mortality of cardiovascular diseases (CVDs) in individuals with MAFLD, the relationship between the degree of liver fibrosis and carotid atherosclerosis is still debated. Aim and objectives: to evaluate the echocardiographic abnormalities and carotid artery atherosclerosis in MAFLD patients. Patients and methods: This cross sectional study was carried out on 49 patients diagnosed with MAFLD at hepatology, gastroenterology outpatient clinic at mahalla hepatology teaching hospital. Results: The mean age ±SD was 43.69 ± 11.36; there were 20.4 % male, 79.6 % female. There was statistically significant correlation between steatosis score and age, AST to platelets ratio, FIB4 score, NAFLD score, systolic blood pressure (SBP), diastolic blood pressure (DBP), fibrosis, triglycerides (TG), total cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL). There was statistically significant correlation between steatosis score and left Carotid and left ventricular global longitudinal strain (LVGLS). Conclusion: we can conclude that MAFLD has a significant association with higher cardiovascular risk in terms of carotid artery atherosclerosis and echocardiographic abnormalities.