Aim: The aim of this study is to elucidate the relationship between visfatin and metabolic syndrome and its relation with IL-6 along with the association with presence of Phosphoinositide 3-kinase (PI3K) polymorphism.Subjects and Methods: Fifty eight patients suffering from liver steatosis divided into Diabetic lean patients (n=16). Diabetic obese patients (n=22) and Metabolic syndrome patients (n=20).Together with Twenty age and sex matched healthy control subjects. lipid profile, Fasting and 2h-post prandial blood glucose, Fasting insulin, Serum visfatin, Serum interlukin-6 (IL-6) were done to all subjects. Detection of met326ill polymorphism in p85α Regulatory Subunit of Phosphatidylinositol 3-Kinase gene was done to only 54 subjects. Results: The present work revealed a significant increase in the levels of serum vifatin in all patients compared with the controls. No correlation was found between vifatin and insulin levels, HOMA-IR or QUICKI in all studied groups. vifatin levels was positively correlated with that of IL-6 levels in all groups. IL-6 levels were elevated in all groups. The frequency of gene mutation (Met326Ile) is least in diabetic lean, rises in diabetic obese, and is highest in metabolic syndrome patents.