The aim of the present study was to compare NAFLD fibrosis score in diabetic and non-diabetic Egyptian patients to clarify the effect of diabetes on the development of fibrosis and NASH in NAFLD patients. This was a comparative anterospective observational study. 50 Egyptian patients with characteristic sonographic features and laboratory findings suggesting Non-alcoholic fatty liver disease were included. The patients were divided into two groups; Diabetic group and Non-diabetic group according to American diabetic association criteria 2015 comparing the NAFLD fibrosis score in both groups which uses six commonly measured parameters. Mean ±SD of NAFLD fibrosis score was -7.5± 0.97 in the non-diabetic group and 1.58± 1.9 in the diabetic group showing significant difference among the studied groups, as the lowest scores were in non-diabetic group, and the highest scores were in the diabetic group. This showing prevalence of advanced hepatic disease in Diabetic group more than non-diabetic group. The lower serum albumin and platelet count in combination with a higher AST to ALT ratio seen with the DM patients reflect the higher prevalence of advanced fibrosis as they are recognized markers of hepatic synthetic function, portal hypertension and surrogates of advanced fibrosis respectively. We concluded that; more aggressive NAFLD as suggested by the higher NAFLD fibrosis score was seen in DM patients compared to non-DM patients.