Background: Obesity is a worldwide epidemic health issue that has increased in recent years. MASLD is considered the hepatic manifestation of metabolic syndrome. The prevalence and severity of MASLD are increasing in parallel with the in-creasing prevalence of obesity. Aim of Study: Study the role of IGF-1 and insulin level in patients with MASH and patients with simple steatosis. Patients and Methods: IGF-1 and insulin levels were measured by ELISA in sixty obese patients thirty patients with MASH compared to thirty patients with simple steatosis as a control group. Results: The serum levels of insulin and HOMA-IR were significantly increased in the MASH patients as compared to the simple steatosis patients. The serum level of IGF-1 was significantly lower in the MASH patients: As compared to the simple steatosis patients. Serum IGF-1 at a cutoff value of 75μg/mL predicted obese MASH patients with a sensitivity of 73.33% and a specificity of 56.67%, while the best cutoff value for insulin was 3.8μg/mL with a sensitivity of 70% and a spec-ificity of 90%. Conclusions: IGF-1 and insulin are promising and cost-ef-ficient biomarkers for discriminating MASH patients from sim-ple steatosis patients and differentiating the stage of fibrosis in obese patients with MASH.