Aim: comparison of the therapeutic effects of metformin, pioglitazone and vitamin E in patients with Non-alcoholic fatty liver disease (NAFLD). Methods: In this clinical trial, 93 patients in Imam Reza Hospital, Kermanshah, diagnosed with NAFLD ( finding on ultrasonography) were randomly divided into three groups. Patients randomized into study groups by 1:1 ratio method using a computer-generated random numbers. Inclusion criteria: Age above 18 year and Non-alcoholic fatty liver disease alone with negative hepatitis serology. Exclusion criteria: clinical manifestation of liver disease, icter, steroid and alcohol use, diabetes, pregnancy, hypothyroidism, renal failure.Each group received group A: 2 gr/daily metformin, group B: 30 mg/daily pioglitazone, group C, 800 IU/daily vitamin E for 12 weeks. Liver function tests, body mass index, hemostatic assessment model, blood glucose and insulin levels were measured before and after treatment.