This study was conducted on 84 patients found to have bright liver on abdominal ultrasonography in addition to healthy individuals served as control group. All cases submitted to history taking, full clinical examination, routine laboratory investigations, serological markers for hepatitis B and C viruses and specific markers (serum adiponectin, leptin, Hs CRP). Liver biopsy was done for 46 patients and according to histopathological examination they were divided into 21 patients with SS and 25 patients with NASH. Serum adiponectin was significantly lower in NAFLD patients than controls and significantly lower in NASH group than simple steatosis group. Serum leptin concentration was significantly lower in NAFLD patients than controls. Adiponectin to lepatin ratio (A/L) was significantly low in all NAFLD cases with lower levels in NASH group. In conclusion: this study shows that in patients with NAFLD serum adiponectin and A/L ratio can discriminate simple steatosis from NASH and predict the severity of liver injury.