 The global increase in obesity and metabolic syndrome has led to a corresponding rise in a number of people suffering from non-alcoholic fatty liver disease, NAFLD. This condition is characterized by excess fat deposits in the liver, and can progress to more serious conditions such as non-alcoholic steatohepatitis, NASH, or even cirrhosis. mitochondrial dysfunction is a key feature of NAFLD, and it is believed that this dysfunction contributes to the progression of the disease. The ketogenic diet, KD, a high fat, low carb diet, has been shown to reduce oxidative stress and improve mitochondrial function. In this review, we examine the evidence for the potential therapeutic role of KD in NAFLD, focusing on how ketosis affects oxidative stress pathways and how it improves liver and mitochondrial function. This article was authored by Antonio Pauley and Giuseppe Cirullo.