Objective: Studies in recent times researching the correlation between serum endotrophinlevel and Type 2 DM have focused on the association of fatty liver with metabolic syndrome.This study aims to research the correlation between serum endotrophin levels, defined asa marker of metabolic dysregulation, with nonalcoholic fatty liver in metabolic syndromepatients, with increasing prevalence.Methods: Our prospective study included 40 patients (24 females and 16 males) with metabolicsyndrome attending the internal medicine clinic and 20 healthy volunteers (ten femalesand ten males). Evaluation of patients in terms of liver steatosis used transabdominal ultrasonographywith a Toshiba 500 Aplio brand model ultrasound device with 10 MHz convexprobe with transient elastography method. Fatty Liver Index and Hepatic Steatosis Index(HSI) were calculated on the basis sample analyses. The endotrophin levels were studiedwith a Sunred enzyme-linked ımmunosorbent assay kit.Results: Endotrophin levels were found to be lower in the group with metabolic syndromecompared to the healthy group and results were statistically significant different (p<0.001).When the mean elastography results for the groups (in m/s and kPa) are compared, therewere statistically significant differences found (p=0.001, p<0.001). There were statisticallysignificant differences between HSI score with serum insulin levels and homeostasis modelassessment results.Conclusion: In our study, a correlation was not found between endotrophin levels and fattyliver. Endotrophin is a parameter with newly discovered effects and is being researched forapplicability and reliability in clinical practice.