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Antonia Pagkali,1 Anastasios Makris,1 Kalliopi Brofidi,2 Aris P Agouridis,3,4 Theodosios D Filippatos2 1School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; 2Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece; 3School of Medicine, European University Cyprus, Nicosia, Cyprus; 4Department of Internal Medicine, German Oncology Center, Limassol, CyprusCorrespondence: Theodosios D Filippatos, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece, Tel + (30)2810392960, Fax + (30)2810392359, Email filtheo@uoc.grAbstract: Non-Alcoholic Fatty Pancreas disease (NAFPD), characterized by fat accumulation in pancreatic tissue, is an emerging clinical entity. However, the clinical associations, the underlying molecular drivers, and the pathophysiological mechanisms of NAFPD have not yet been characterized in detail. The NAFPD spectrum not only includes infiltration and accumulation of fat within and between pancreatic cells but also involves several inflammatory processes, dysregulation of physiological metabolic pathways, and hormonal defects. A deeper understanding of the underlying molecular mechanisms is key to correlate NAFPD with clinical entities including non-alcoholic fatty liver disease, metabolic syndrome, diabetes mellitus, atherosclerosis, as well as pancreatic cancer and pancreatitis. The aim of this review is to examine the pathophysiological mechanisms of NAFPD and to assess the possible causative/predictive risk factors of NAFPD-related clinical syndromes.Keywords: non-alcoholic fatty pancreas disease, NAFPD, steatotic pancreatic disease, metabolic dysfunction-associated steatotic pancreatic disease, MASPD