NAFLD is a common cause of chronic liver disease with a global prevalence of about 25%. The highest prevalence of NAFLD is in the Middle East. Given the global epidemic of obesity and type 2 diabetes (T2DM), these prevalence rates are increasing across the world. The increasing prevalence of NAFLD has led to higher burden of disease. Recent data from global burden of disease (GBD) suggest that in most regions of the world there are increases in the rates of mortality from NAFLD-related cirrhosis and HCC. Additionally, Disability Life Years (DALYs) are negatively impacted by NAFLD. In fact, more than half of NAFLD related liver complications are experienced in Asia, the Middle East and North Africa (MENA). This increasing burden is driven by metabolic and dietary risk factors. Additionally, in MENA region of the world, lower activity is also responsible for driving the disease burden. It is important to recognize that a large proportion of NAFLD patients from the Asian countries are considered lean. These individuals are less metabolically abnormal than obese NAFLD patients, about a third of these patients still have T2DM or dyslipidemia. Long-term outcomes of lean NAFLD remain controversial. Although some studies from Asia and Europe suggested lower risk of mortality, data from USA and France suggest higher rates of mortality. In addition to adverse clinical outcomes (cirrhosis, mortality etc.), NAFLD patients experience impairment of health-related quality of life (HRQL) and other patient-reported outcomes (PROs). In this context, it is important to recognize that NAFLD is not an asymptomatic disease. Fatigue is common in NAFLD and can negatively influence patients’ HRQL. Economic analyses of NAFLD suggest high economic burden in most regions of the world. Since NAFLD is a global disease, clinical, PRO and economic burden of NAFLD must be assessed from a regional and global perspective.