Non-alcoholic fatty liver disease (NAFLD) is a metabolic syndrome and major chronic liver disease that can lead to liver cirrhosis, liver cancer and ultimately death. Although its progression rate may be slower than that other types of liver disease and the incidence of which is rising rapidly due to the increasing epidemic of obesity in both children and adults, worldwide. The accumulation of fat followed by subsequent inflammation is central to the development of liver injury, and is influenced by host factors including age, gender, presence of diabetes, genetic polymorphism and recently gut microbiome. NAFLD is also a risk factor of cardiovascular disease, which is the commonest cause of mortality. The natural history of NAFLD remains unclear. Lifestyle modification that including diet, exercise and weight reduction may be the best way to manage disease and one of the best advice for patients. This review focusses on the pathogenesis and evolution of new approaches to the management and treatment of NAFLD.