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Non-alcoholic fatty liver disease (NAFLD) affects up to a third of the population in developed countries. Between 10% and 30% of patients with NAFLD have non-alcoholic steatohepatitis (NASH). There are metabolic risk factors common to both NAFLD and cardiovascular disease, so patients with NASH have an increased risk of liver-related and cardiovascular death. This articles reviews the most recent advances in the management of NAFLD in five main areas: lifestyle modification, weight loss treatment, therapy for metabolic syndrome, insulin sensitizer and antioxidant pharmacotherapy, and management of end-stage liver disease. It is pointed out that clinicians need to pay more attention to metabolic syndrome in the diagnosis and treatment of NAFLD. [ABSTRACT FROM AUTHOR]