Fatty liver disease is one of the commonest reasons for visiting a Hepatologist. Fatty tissue slowly builds up in the liver when a person’s diet exceeds the amount of fat his or her body can handle. Simple fatty liver can be a completely benign condition and usually does not lead to liver damage. However, once there is a build up of simple fat, the liver becomes vulnerable to further injury, which may result in inflammation and scarring of the liver. The most common causes associated with fatty liver disease are alcohol consumption and obesity in a patient who is either a diabetic, hypertensive or has dyslipidemia. The treatment is cessation of alcohol consumption and in obese patients lifestyle modification, weight loss, and physical activity in order to reduce the amount of fat in the liver. Patients with diabetes and high lipids in their blood have to improve their sugar control and lower the lipids levels.