Non-alcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in the world. Absence of significant amount of alcohol consumption (<40 g of ethanol/week) is essential for diagnosis of NAFLD. It includes a spectrum of conditions with hepatic steatosis in the absence of significant alcohol use. The spectrum of NAFLD includes fatty liver/hepatic steatosis (FL), fatty liver with nonspecific inflammation (FL-N) and nonalcoholic steatohepatitis (NASH). Fatty liver with or without nonspecific inflammation is believed to have a benign course. Non-alcoholic steatohepatitis (NASH) can progress to cirrhosis, leading to liver failure and hepatocellular carcinoma. Liver transplant survival rate seems to be similar to the recipients with other chronic liver diseases. More importantly, recurrence of FL and NASH after liver transplantation occurs and can be severe enough to lead to allograft failure. In USA, approximately 7% of liver transplantations are undertaken for cryptogenic cirrhosis. The patients transplanted for cryptogenic cirrhosis, steatosis is likely to develop if the underlying cause is NASH. Recurrent of NASH after LTX is reported to be as 11% to 38%. Increased prevalence of recurrent steatosis and NASH may be explained in terms of the metabolic derangements and immunosuppression related dyslipidemia commonly seen after liver transplantation.