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Background: Non-alcoholic fatty liver disease (NAFLD) is considered as the most common chronic liver disease, which can contribute to some clinical conditions varying from simple steatosis to hepatic cirrhosis. Consequently, the early diagnosis of NAFLD is vital. The present study aimed at investigating the ability of FLI (fatty liver index) in predicting NAFLD. Methods: A total of 212 individuals over the age of 18 years (103 males and 109 females) were recruited from those admitted to a gastrointestinal clinic in Mashhad, northeastern Iran. Anthropometric parameters were measured and blood samples were collected. Hepatic steatosis and fibrosis were identified by FibroScan. FLI from body mass index, waist circumference (WC), triglyceride, and gamma glutamyltransferase data were calculated. Logistic regression was applied to establish a relationship among FLI, hepatic steatosis, and fibrosis. The sensitivity and specificity of FLI and its optimal cut-off point were detected by receiver operating characteristic analysis. Results: The mean age of the participants was 39.26 ± 14.18 years. FLI was significantly associated with NAFLD (OR = 1.062, 95%CI: 1.042 - 1.082, P < 0.001) and hepatic fibrosis (OR = 1.022, 95%CI: 1.011 - 1.032, P < 0.001). The AUC of FLI was 0.85 (95%CI = 0.79 - 0.9) in the diagnosis of NAFLD, and its optimal cut-off point was 26.2 (sensitivity = 0.83, specificity = 0.7). Also, the optimal cut- off point of FLI was 30.4 in males (sensitivity = 0.82, specificity = 0.71) and 20.7 in females (sensitivity = 0.89, specificity = 0.66). Conclusions: Fatty liver index (FLI) is a suitable and simple predictor for liver steatosis. However, performance of FLI in predicting NAFLD is not more effective than WC. Although FLI is a predictor for liver steatosis, it has a positive association with liver fibrosis and can perhaps predict liver fibrosis too. [ABSTRACT FROM AUTHOR]