Background: Metabolic syndrome describes the co-occurrence of central adiposity, hyperglycemia, hypertension, lipid abnormalities and other metabolic changes that increase risk of cardiovascular, cerebrovascular, renal diseases. Non-alcoholic fatty liver disease (NAFLD) is associated with a substantial increased risk of cardiovascular disease (CVD), which is partly related to low HDL-C level. This multi-system condition has adverse effects on many organs, the liver being one of them. Non-alcoholic fatty liver disease appears to be the hepatic manifestation of metabolic syndrome, and is increasingly recognized as a major contributor to the burden of chronic liver disease world-wide. Objective: To find out the Association of Low HDL of NAFLD Patients With or Without Metabolic Syndrome. Materials and Methods: This is a cross sectional descriptive study which was conducted in the Department of Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh. 250 patients age above 20 years nonalcoholic both male and female were included for the study. All patients were interviewed by structured questionnaire. Statistical analysis was carried out by using the Statistical Package for the Social Sciences (SPSS) software version 23.0 for windows (SPSS Inc, Chicago, Illinois, USA). Results: Among 250 respondents a total of 67(26.8%) cases were diagnosed as metabolic syndrome and out of the 67 metabolic syndrome patients 23(34.33%) were male and 44(65.67%) were female. Out of the 23 male metabolic syndrome patients 9(39.13%) were diagnosed as NAFLD and out of the 44 female metabolic syndrome patients 16(36.36%) were diagnosed as NAFLD. Out of the 53 NAFLD patient’s 25 patients were presented with metabolic syndrome and 28 patients were without metabolic syndrome. Patients of NAFLD with metabolic syndrome presented with low HDL in 16(64%) cases. The difference was significant for high-density lipoprotein and waist circumference (p<0.05) between metabolic syndrome and non-metabolic syndrome patients. Conclusion: From the study, it can be concluded that the proportion of NAFLD significantly higher in metabolic syndrome patients compare to non-metabolic syndrome patients and metabolic syndrome is higher in female compare to male. The results of this study indicate that central obesity and dyslipidemia, with low HDL cholesterol, are important associates of NAFLD in patients.