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The first cause in the pathogenesis of NAFLD is oxidative stress. Hypercholesterolemia is frequent in NAFLD patients. Red rice is administered in patients with mild hypercholesterolemia or in patients intolerant to statins. Red rice is rich in sterols and isoflavonoids with potential effects on oxidative stress. to evaluate the role of red rice on parameters of oxidative stress and on biomarkers of liver steatosis in patients with NAFLD. we studied 24 patients (14 F, 10 M) with mean age ± SD (50.9±11.9 yrs) affected by NAFLD, with mild hypercholesterolemia. Patients with Type 2 diabetes and patients on treatment with statins were excluded. We measured the following parameters of oxidative stress: Malondialdehyde (MDA) and Glutathione-disulfide (GSSG). Calculated the scores of liver steatosis (FLI, HIS, NAFLD-LFS) and the scores of fibrosis (APRI, FIB-4, NFS). The liver fibrosis was also detected by ARFI methods (Simens S-2000). The body composition was calculated with Bioimpedentiometry (BIA). All the parameters were detected at T=0 and after 6 months (T=6) of therapy with 10 mg of Monakoline K. all the patients completed the study. The body weight was stable, and no modifications on BIA parameters were observed. The total cholesterol and total triglycerides declined (232.05±22.01 mg/dl to 204.15± 35.80 mg/dl p < 0.003; 135.60±99.90, to 130,80±46.80 mg/dl p< 0.026, respectively). ALT was also reduced (51.45±26.86 U/L to 34.40±17.57 U/L p< 0.18). MDA and GSSG decreased significantly (10.90 ±4.20 mM to 5.15±2.78 mM p< 0.0001; 3.15±1.83 µM to 1.02±0.98 µM p<0.0001, respectively). The FLI was reduced by 75.69±18.01 to 64.93±4.96 p< 0.035, while HIS and NAFLD-LFS and scores of fibrosis were unchanged. Red Rice after six months of therapy in patients with NAFLD and mild Hypercholesterolemia reduced significantly the parameters of oxidative stress, the score of fatty liver FLI, and the parameters of hepatic cytonecrosis. [ABSTRACT FROM AUTHOR]