Background: At the junction between obesity, metabolic syndrome and liver failure, lies Non-alcoholic fatty liver disease. Recent studies elaborated on role of metformin in patients with non-alcoholic fatty liver disease. This observation has not been studied at a global scale, neither it was investigated in different ethnical groups. Objectives: We aim at determining the risk factors associated with prognosis of non-alcoholic fatty liver disease among a cohort of patients in Southern West Bank, Palestine. Methods: A retrospective cohort study involving 300 NAFLD patients who visited the internal medicine department at Hebron Governmental Hospital from October 2017 till September 2018. Two hundred and three patients diagnosed with non-alcoholic fatty liver disease, were included in this study. Lab test results within the past 6 months, comorbidity and medication history were collected from patients` profiles. Data was analyzed using SPSS V20. Liver Fibrosis score was determined by using non-alcoholic fatty liver disease fibrosis score calculator. Results: Two hundred and three non-alcoholic fatty liver disease patients (58.6% females), 54.78 (±12.27) years old were included in the study. Almost 65.5% of these patients have BMI >30 Kg/m2. It was found that, 62.25% of the 58 diabetic patients in this study had liver fibrosis score > 0.676 comparing to non-alcoholic fatty liver disease patients who are non-diabetic. There was a significant relationship between diabetes and fibrosis score, α=0.000. There was also a significant relationship between hyperlipidemia and fibrosis score of non-alcoholic fatty liver disease patients, α=0.023. We found a significant relationship between fibrosis score and hypertension, α=0.000. In the same context, there was a significant relationship between NAFLD patients who were on statin therapy and those who were not using statin therapy, α= 0.015. Metformin was not associated with significant relationship between users and non-users non-alcoholic fatty liver disease subjects. Conclusion: Diabetes mellitus, hypertension, hyperlipidemia and statin use were associated with NAFLD prognosis.