Non-alcoholic fatty liver disease represents a spectrum of liver diseases which occurs in the absence of alcohol consumption in amounts considered injurious to the liver. Non-alcoholic fatty liver disease includes both non-alcoholic fatty liver and non-alcoholic steatohepatitis. We present an integrated approach that utilizes both clinical and laboratory studies to diagnose and manage a patient with suspected non-alcoholic steatohepatitis. The goals of treatment include (1) correction of the underlying risk factors, (2) avoidance of factors that promote progression of liver disease, and (3) specific treatment of non-alcoholic steatohepatitis.