Abstract: Objective To study the association between the microsomal triglyceride transfer protein (MTTP) gene and hereditary risk of non-alcoholic fatty liver disease (NAFLD). Methods Peripheral blood DNA from 219 patients diagnosed with NAFLD and 210 control subjects were used to determine the MTTP genotype by polymerase chain reaction (PCR) and direct sequencing. Inter-group differences and associations were assessed statistically using t tests, Chi square and logistic analysis. Results There were significant differences in the frequencies of rs1800591 genotype and allele between the NAFLD and control subjects (χ 2 = 9.007, P = 0.011; χ 2 = 9.599, P = 0.002）. Logistic regression analysis adjusted for confounding factors showed that the OR of carriers with the GG + GT genotype of rs1800591 developing NAFLD was 1.623, (95%CI: 1.070～1.648, P = 0.030), compared with those with TT genotype. Also, in contrast with T allele, there was an increased risk of NAFLD for rs1800591 G allele (OR = 1.521, 95%CI: 1.089～2.123, P = 0.014). The levels of ALT, LDL and TG were higher in GG + GT genotype than that in TT genotype, with significant differences. Conclusions The polymorphism rs1800591 in MTTP is related to the risk of NAFLD.