Background and Objectives:Childhood obesity has become an epidemic, and morbid obesity affects a significant portion of the population in India. The most prevalent type of chronic liver ailment in overweight and obese children worldwide is nonalcoholic fatty liver disease. This study is undertaken to assess the prevalence of NAFLD and associated risk factor among overweight and obese children.Methods:This cross-sectional study was carried out in 230 overweight and obese children aged 5-15 years, who visited the pediatric outpatient department of a tertiary care hospital in Jharkhand. Measurements included anthropometry, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lipid profile and ultrasonography to diagnose NAFLD. The variables were compared between participants with and without NAFLD, and logistic regression analysis was performed.Results:The prevalence of NAFLD was 44% among overweight and obese children, while BMI, history of hypertension in family, gestational hypertension, exclusive breastfeed, serum cholesterol, triglyceride, LDL-C, ALT and AST were statistically associated with participants with NAFLD. On multiple logistic regression analysis serum cholesterol, triglyceride, LDL-C and ALT were independently associated with NAFLD with odds ratio (95% confidence interval) of 19 (1.3 - 279.1, P value = 0.03), 17 (1.6 - 200, P value = 0.02), 46 (3.9 - 541.7, P value = 0.002) and 161 (3.4 - 7524.6, P value = 0.01), respectively.Conclusion:An independent association was observed for serum cholesterol, triglyceride, LDL-C and ALT in overweight and obese children with NAFLD.