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Abstract Background:NAFLD and obesity are emerging as important health problems and associated with high risk for cardiovascular diseases. Objective: Evaluating the relationship between presence and severity of coronary atherosclerosis and NAFLD and obesity in patients undergoing coronary angiography. Methods: In this observational study, the study group consisted of 50 patients (mean age: 56.2 ± 7.1 years) that comply with inclusion criteria and selected out of 119 patients who underwent coronary angiography. CAD was defined as detection of at least 50% narrowing in any of the epicardial coronary arteries or their major branches. Severity of CAD was quantified using the SYNTAX score. Abdominal ultrasonography was performed for detection of fatty liver. Obesity was defined as BMI {u2265} 30 kg/m2. Statistical evaluations were performed using Mann Whitney, Kruskal Wallis, Chi square and Fisher{u2019}s tests and multivariate linear regression model. Results: NAFLD prevalence was 74%, while obesity prevalence was 70%. There was a significant association between the number of diseased coronaries and smoking, BMI, obesity, fatty liver, AST and ALT. There was a positive correlation between SYNTAX score and BMI (r = 0.6, P < 0.001), AST level (r = 0.312, P = 0.028) and ALT level (r = 0.307, P < 0.030). There was a significant association between SYNTAX score and BMI, obesity and fatty liver. The same findings were shown after classification of patients into groups of CAD severity according to SYNTAX score. However, there was a significant association with AST which may be explained by inclusion of MI patients who have elevated AST levels |