Background; Prevalence of coronary, cerebrovascular and peripheral vascular diseases in the people with non alcoholic fatty liver disease (NAFLD) has been increased. It is largely unknown if the relationship among NAFLD and the cardiovascular risk factors, CRP, metabolic syndrome and the Framingham risk score with taking into consideration the other potential confounding factors. Subjects and Methods; 30,172 subjects were included for study. The subjects were divided into the controls (no steatosis on ultrasound and a serum ALT<30U/L in men and ALT<19 U/L in women), the increased serum ALT group (ALT ���30U/L in men and ALT ���19 U/L in women), the steatosis group (with an ALT<30U/L in men and ALT <19 U/L in women) and the ���NASH(non alcoholic steatohepatitis)��� group (steatosis and an ALT���30U/L in men and ALT ���19 U/L in women). Results; Triglyceride and low density lipoprotein cholesterol, apolipoprotein B levels were higher but the apolipoprotein A and high density lipoprotein cholesterol levels were lower in the NAFLD group (increased ALT or steatosis) and in the NASH group. The odds ratios for 10-year risk by total Framingham risk scores���10% were 1.23 to 5.26 times higher in NAFLD or NASH groups. Diabetes, hypertension, elevated CRP and metabolic syndrome were all increased up to 15 fold over the controls, and this was independent of age, BMI, smoking and exercise habits. Conclusion: Subjects with NAFLD or NASH should be aggressively treated not only for their liver disease, but also for their underlying cardiovascular risk factors.