Serum vitamin D level is deficient in many metabolic diseases and NAFLD. To discern the level of vitamin D among the patients with Obesity, Diabetes mellitus, Hypothyroidism, Dyslipidemia, Metabolic syndrome and NAFLD. A prospective hospital based observational study conducted from May 2019 for twelve months period in Medicine department, Bir hospital, NAMS, Nepal. Seventy patients with known fatty liver and its severity as assessed by Ultrasonogram after sorting out the exclusion criteria were enrolled. Patients were evaluated for Vitamin D level and its effects on obesity, diabetes mellitus, thyroid related disease, NAFLD and dyslipidemias. The level of vitamin D is correlated with the grade of the fatty liver and fibrotic stages of liver assessed by 2 d shear wave elastography. Baseline Characteristics among seventy patients, male were 39(55.7%) and female were 31(44.3%) with mean age of the patients being 44.3 years. Among them, overweight with mean BMI of 28.2, kg/m2and most of them were of more than 25kg/m2being 51(72.9%). Diabetes mellitus was 41.4%, hypertension in 77.1%, hypothyroidism in 30% and metabolic syndrome in 25.9%.More than 90% of vitamin D level is insufficient in all Metabolic diseases. The grade of fatty liver by ultrasound were mild in 64.28%, moderate in 25.72% and severe in only 10 %.The mean fibrosis of 7.07 kpa was noted in Mild grade fatty liver, similarly mean fibrosis of 8.22 kpa in Moderate grade and 18.16 kpa in severe grade of fatty liver. The mean value of vitamin d for Mild grade were 22.61iu/ml, Moderate grade 24.89 iu/ml and for severe 17.4 iu/ml . The high prevalence of Vitamin D insufficiency is noted in individuals with obesity, Diabetes mellitus, Metabolic syndrome, Hypothyroidism, Dyslipidemia and NAFLD. The level of vitamin D is directly associated with the grade of fatty liver and the stages of fibrosis