Non-alcoholic fatty liver disease (NAFLD) has been described as the hepatic manifestation of the metabolic syndrome and its prevalence has increased together with obesity and diabetes rates worldwide1,2. Population-based studies describe the prevalence of NAFLD to be between 14-31% in Europe and America3. In Asian-Pacific countries, it been estimated at 9-30%, with higher rates of 10-80% amongst obese patients, 30-90% in patients with diabetes and 15-69% in patients with dyslipidaemia4. NAFLD is a common medical condition, especially among patients who are have the metabolic syndrome, and will frequently present to the family physician. The purpose of this clinical review is to outline an approach to the diagnosis and management of NAFLD in primary care.