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Background: Non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) are two closely related diseases, that consist mainly in excess fat accumulation in the liver. They share many risk factors and pathophysiological mechanisms. Metabolic risk factors include obesity, altered glucose metabolism, hypertension and dyslipidemia. Objective: The aim of the study was to compare risk factors of metabolic syndrome and non- alcoholic fatty liver disease in our clinic. Material and methods: A retrospective observational study was performed, including 60 patients diagnosed with NAFLD. The patients were admitted to the gastroenterology department of the "Mures County Clinical Hospital" in Targu Mures, Romania, from January 2023 to December 2023. Included were patients with a secured NAFLD diagnosis above the age of eighteen. The patients were grouped into two study groups: positive for NAFLD and positive for NAFLD and MetS. Excel and Jamovi were used for the statistical analysis. Results: No statistically significant differences were found in the demographic comparison of the study groups (age, gender, environment). The presence of metabolic risk factors was significantly higher in the group including MetS diagnosis, compared to the NAFLD only group: overweight/obesity (92,9% vs 58,7%, p=0.01), diabetes mellitus (78,6% vs 4,3%) or impaired fasting glucose (21,4% vs 4,3%) with p<0.001 and hypertension (100% vs 58,7%, p<0.01). Patients with NAFLD and metabolic syndrome either had three (57,1%) or all four (42,9%) of the risk variables listed (p=<0.001). 8,7% of the NAFLD group showed three risk factors, 45,7% showed two, 34,8% showed one, and 10,9% showed no metabolic risk factor (p<0.001). No significant differences were found in the analysis of various laboratory values and when comparing pulmonary, renal, neurological, oncological comorbidities. Conclusions: In addition to having an impact on the diagnosis of MetS, metabolic risk factors also typically influence, albeit to a lower degree, the development of NAFLD. [ABSTRACT FROM AUTHOR]