Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease, extending from simple steatosis to inflammation and fibrosis with a significant risk for the development of cirrhosis. It is highly prevalent and is associated with significant adverse outcomes and is closely associated with type 2 diabetes and obesity, and both of these conditions drive progressive disease toward the more advanced stages. The ability to make an accurate assessment of disease stage can also be challenging. Liver biopsy is still regarded as the gold-standard investigative tool, but there is a continued search for novel non-invasive biomarkers and imaging modalities that accurately reflect disease stage. Finally, although no therapies are currently licensed for the treatment of NAFLD, there are interventions that appear to have proven efficacy in randomized controlled trials as well as an emerging therapeutic landscape of new agents.