OBJECTIVE: To describe clinical and biochemical features of patients with biopsy-proven non-alcoholic fatty liver disease (NAFLD). STUDY DESIGN: Case-series. PLACE AND DURATION OF STUDY: Medical Unit of Rawalpindi Medical College, Rawalpindi, from July 2005 to July 2006. PATIENTS AND METHODS: Fifty patients of either and of all ages were included, who had ultrasound evidence of fatty liver, deranged liver enzymes, and negative history of alcohol uptake. Serological/biochemical tests/markers of other liver diseases were negative. Each subject underwent liver biopsy reported by a single histopathologist. Clinical (symptoms, hypertension, hepatomegaly, and obesity) and biochemical evaluation (for diabetes, lipid abnormalities, and aspartate to alanine aminotransferase ratio [AST/ALT]) of each subject was done. Chi-square and t-tests were used for p-value calculation for finding significant difference between fatty liver and non-alcoholic steato-hepatitis groups. RESULTS: Thirty three (66%) patients were female and 34% were male. Mean age was 45.50 +/- 11.50 years. Histopathologically, 62% subjects had fatty liver alone, while 38% had nonalcoholic steatohepatitis (NASH). Fatigue (100%), hypertriglyceridemia (80%), hepatomegaly (72%), AST/ALT ratio < 1 (72%), and obesity/overweight (54%) were common NAFLD-related features. Except for hypertriglycedemia (p-value 0.008), no statistically significant association was noted between these features and histopathological subtypes of NAFLD. CONCLUSION: NAFLD-related clinical and biochemical features included fatigue, obesity, hepatomegaly, AST/ALT ratio<1, and hypertriglycedemia. Significant relationship existed between hypertriglyceridemia and NASH.