Non–alcoholic fatty liver disease(NAFLD) is a marker of pathological ectopic fat accumulation combined with a low–grade chronic inflammatory state. This results in several deleterious pathophysiological processes including abnormal glucose, fatty acid and lipoprotein metabolism, increase oxidative stress, deranged adipokine profile, hypercoagulability, endothelial dysfunction, and accelerated progression of atherosclerosis.NAFLD  affects up to a third of the population worldwide and may confer increased cardiometabolic risk with consequent adverse cardiovascular outcomes independent of traditional cardiovascular risk factors and the metabolic syndrome. It is characterized almost universally by insulin resistance and is strongly associated with type 2 diabetes and obesity. This ultimately leads to a dysfunctional cardiometabolic phenotype with cardiovascular mortality representing the main mode of premature death in NAFLD. This article aims  at discussing in–depth the evidence to date linking NAFLD with cardiovascular disease & reviewing the likely mechanisms underlying this association.