Non-alcoholic steatohepatitis (NASH) is a progressive form of Non-alcoholic fatty liver disease (NAFLD), characterized by steatosis, inflammation, and hepatocyte ballooning injury. The prevalence of NASH has been increasing with the trend of increasing risk factors. Despite the fact that the drug-based therapeutic interventions have not proved to be much effective, an appropriate intervention is needed to prevent disease progression in people with high risk-factors. Overall weight loss and exercise remain the key to improvement in the histopathological features of NASH including portal inflammation and fibrosis. Dietary supplementation of long-chain polyunsaturated fatty acids and antioxidant supplementation have been shown to be beneficial whereas high intake of fructose is implicated in NASH pathogenesis. Biomarkers including cytokeratin-18 (a marker of hepatocyte apoptosis and necrosis), markers of liver fibrosis, and markers of inflammatory stress and lipotoxicity may be beneficial in the differentiation of disease progression correlating with the gold standard. Additionally, understanding the role of genetic variations such as with PNPLA3, TM6SF2, and others, associated with NAFLD, in the metabolic and inflammatory pathway along with other risk factors may help in translating the information into clinical practice. In this review, we summarize current strategies for the treatment of NASH based on targeting the risk factors and controlling predisposing factors
