Background: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and is closely associated with obesity, insulin resistance, type 2 diabetes mellitus, dyslipidemia, and metabolic syndrome. The disease spectrum ranges from simple hepatic steatosis to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Early recognition of clinical characteristics is essential for preventing disease progression.Objective: To evaluate the demographic profile, clinical presentation, metabolic risk factors, laboratory abnormalities, imaging findings, and clinical outcomes of patients diagnosed with non-alcoholic fatty liver disease.Methods: A hospital-based retrospective observational study was conducted among 260 adult patients diagnosed with NAFLD over an 18-month period. Demographic data, anthropometric measurements, laboratory investigations, abdominal ultrasonography findings, fibrosis assessment, associated metabolic disorders, treatment, and outcomes were analyzed.Results: The mean age of patients was 49.8 ± 12.6 years, with males accounting for 57.3% of cases. Obesity (61.9%), diabetes mellitus (44.2%), dyslipidemia (51.5%), and hypertension (46.2%) were common associated conditions. Fatigue (46.9%) and right upper quadrant discomfort (35.8%) were the most frequent symptoms, although 39.2% of patients were asymptomatic. Ultrasonography demonstrated Grade I fatty liver in 45.8%, Grade II in 37.7%, and Grade III in 16.5% of patients. Elevated alanine aminotransferase (ALT) was observed in 67.3%, while significant fibrosis was identified in 18.8% of patients. Lifestyle modification resulted in clinical improvement in 81.5% of patients during follow-up.Conclusion: NAFLD is strongly associated with obesity and metabolic syndrome. Most patients present with mild disease; however, a substantial proportion develop advanced fibrosis. Early diagnosis, weight reduction, lifestyle modification, and management of metabolic risk factors are essential to prevent progression to advanced liver disease.