Abstract: Background: Multiple sclerosis (MS) is a complex inflammatory, demyelinating and neurodegenerative disease with a heterogeneous pathology and clinical outcomes. Chronic inflammatory processes characterizing MS is claimed to be linked to systemic lipid metabolism and insulin resistance (IR). Aim: To assess the metabolic changes in MS patients and their relation to liver function. Patient and method: This case-control study included 30 individuals. They were divided into 2 equal sex and age matched subgroups; MS and control groups. For each group, lipid profile, glucose, insulin levels, HOMA-IR indices, aminotransferases, tumor necrosis factor-α (TNF-α) and Creactive protein (CRP) were measured. Brain MRI and abdominal ultrasonography were done. Results: there was a significant elevation in glucose, insulin, HOMA-IR, TNF-α, CRP associated with dyslipidemia in MS group. However, there was no difference in aminotransferases levels between groups. Abdominal US revealed fatty liver in 66.7% of patient group vs 13.3% in control group. Conclusion: Inflammatory process and IR in MS patient is associated with non alcoholic fatty liver disease (NAFLD).