Background : Helicobacter pylori is a common bacteria that is present in about half of all population. H pylori infection causes atrophic and even metaplastic changes in the stomach; this infection is also linked to peptic ulcer disease and systemic inflammation that alters metabolism.  Objective: To investigate the prevelance of H- pylori infection among Egyptian adults its association with Metabolic dysfunction associated fatty liver disease (MAFLD) Methods:  The study will involve 200 patients 100 cases and 100 control . Height and weight were measured and calculation of BMI (BMI = kg/m2), waist & hip circumference were measured, Blood pressure was assessed by mechanical monitor (systolic& diastolic). Degree of fibrosis (FIB4, APRI) was measured . H pylori antigen in stool was done. Ultrasonography & Fibroscan of the liver was performed .Results: Our results showed there is a significant difference between both groups (P-value 0.001) regarding the following: The H. pylori were positive in 79% of the case group, while only 33% of the control group were positive. The bright Hepatomegaly was positive in 93% of the case group, and the whole control group was negative (normal). The Fibroscan, the control group had F0 (45%) and F1 (55%) while the distribution among the case group was significantly different F0 (2%), F1 (44%), F2 (38%) and F3 (16%). Conclusion: H.pylori infection is a risk factor for developing MAFLD in Egyptian patients.