Nonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions in the last decade, and it is related to high cardiovascular mortality. This disorder encompasses a spectrum of increasingly severe clinicopathological conditions, i.e. nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) with or without fibrosis/cirrhosis. Mortality associated with NAFLD is significantly higher in patients with the more advanced stages of this condition and is chiefly due to concomitant cardiovascular disease. The association between NAFLD severity and carotid artery intima-media thickness (CIMT) is controversial.