The clinical importance of non-alcoholic fatty liver disease (NAFLD) in pregnant women has not been adequately established, despite the abundance of data linking it to altered glucose homeostasis. The aim and objectives were to examine the link between NAFLD in the first trimester of pregnancy and gestational diabetes mellitus (GDM). Subjects and methods were 50 singleton pregnant women who received prenatal care in the first trimester at Beni-Sweef General Hospital obstetrics and gynaecology department were included in this cross-sectional. In pregnant women, high-grade steatosis increases the risk of developing gestational diabetes mellitus (GDM). The chance of developing GDM in the middle of pregnancy increases when NAFLD is present in the early stages of pregnancy. To determine and describe the underlying processes causing this connection, further mechanistic research is required.