Introduction: Acute liver failure (ALF) may be fulminant. Fulminant hepatic failure is characterized by the development of hepatic encephalopathy within 8 weeks after the onset of acute liver disease. Coagulopathy is invariably present. A thiol-containing agent, N-acetylcysteine (NAC) scavenges free radicals of oxygen and nitrogen. Its use in Non acetaminophen induced (NAI) ALF is still not being used as regular practice due to variable results of studies. This study was designed to evaluate the outcomes of NAC in NAI-ALF patients in terms of their early recovery, ICU stay and safety index of the drug. Methods: A cross- sectional prospective study was done in two private hospitals from March 2007 to February 2008. Group I included patients with NAC and conventional treatment and Group II consisted of conventional treatment only. Results: Total of 55 patients with acute hepatic failure without drug intoxication were admitted during the study period. They were randomly divided into two groups. Out of 55 patients, 30 were in Group I and 25 were in Group II. In Group I out of 30 patients 3 died with a success of treatment in 90.0% cases and in group II out of 25 patients 4 died with the success rate of 84%. Conclusion: Role of N-Acetylcysteine in Acute Hepatic Failure is encouraging. Therefore it is recommended that patients with acute hepatic failure may preferably be given NAC along with conventional treatment rather than treating them with conventional regimen alone.