Hepatocytes that have an excess accumulation of triglycerides experience hepatic steatosis. Alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD) are the two main diseases linked to hepatic steatosis. Moreover, the pathogenesis of hepatic steatosis includes various factors like metabolic, dietary, as well as HCV infection. The liver primarily produces fetuin A, a multifunctional plasma glycoprotein. Increased Fetuin A was related to obesity and its associated complications, including T2DM, metabolic syndrome, and NAFLD. The objective of this research was to see if the fatty liver index (FLI) and serum Fetuin A could be used as an early predictor for hepatic steatosis in patients with chronic HCV. This research included 90 persons who were divided into 3 groups: Group I: comprised 30 patients with NAFLD (steatosis) who were free of other chronic liver diseases. Group II: comprised 30 patients with hepatic steatosis and chronic HCV. Group III: a control group of 30 healthy people. All individuals experienced demographic, clinical, laboratory tests (Fetuin A level) and abdominal ultrasound; Fatty Liver Index (FLI) was calculated. Fetuin A levels in group II were significantly higher than in groups I and III, and significantly greater in group I than in group III. Both groups I and II exhibited a highly significant rise in the Fatty Liver Index (FLI) when compared to group III, but groups I and II exhibited no significant difference. Fetuin A has a good diagnostic value with high sensitivity and specificity in differentiating between steatosis in NAFLD and HCV related steatosis. It can be employed as a simple, non-invasive test in predicting HCV-related steatosis.