Background: Attempts have been made to recognize noninvasive markers for the identification of non-alcoholic fatty liver disease (NAFLD). Chemerin is a newly defined adipokine linked to insulin resistance and adipogenesis. Objective: This study intended to evaluate the diagnostic ability of serum chemerin compared with NAFLD fibrosis score as a noninvasive marker for the diagnosis and grading of NAFLD. Patients and methods: We enrolled 60 NAFLD patients and categorized them into 3 subgroups based on the fatty liver grade by ultrasound. Thirty healthy participants were recruited as a control group. ELISA method was used for serum chemerin levels measurement. Results: Serum chemerin levels were significantly higher in NAFLD cases than controls (p ≤ 0.001). Furthermore, these levels were positively correlated with the fatty liver grade (p ≤ 0.001). Serum chemerin was comparable to NAFLD fibrosis score as regards NAFLD diagnosis (p ≤ 0.001). Patients within the gray zone of NAFLD fibrosis score had a significantly higher serum chemerin levels in comparison to patients under the gray zone (p ≤ 0.001). Conclusion: Serum chemerin is a promising marker for diagnosing and grading of NAFLD. More research is required to determine its definitive clinical benefit in patients with NAFLD. [ABSTRACT FROM AUTHOR]