Nonalcoholic fatty liver disease (NAFLD) is a common condition that may progress to end-stage liver disease. Recently, NAFLD has been recognized as a hepatic manifestation of metabolic syndrome and an independent risk factor for cardiovascular disease. Therefore, appropriate management of this common disorder is an important public health issue. The management of NAFLD is based on gradual weight loss through lifestyle modification. Reducing total calorie intake and carbohydrates in the diet is beneficial for NAFLD patients. Regular exercise reduces hepatic fat content independent of weight loss. However, such lifestyle changes are difficult to maintain long term for most patients. Despite the growing need for pharmacologic therapy, there is currently no effective agent for the treatment of NAFLD. Several large clinical trials have shown promising but inconsistent effects of pioglitazone and vitamin E for improving NAFLD. However, larger clinical trials are required before definitive conclusions can be drawn.