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To the Editor Non-alcoholic fatty liver disease (NAFLD) represents a clinical condition that may progress from steatosis to steatohepatitis, cirrhosis and hepatocellular carcinoma. There are not enough information about the relationship between menopause and NAFLD, and this study evaluated the relevance of this liver disease in menopausal women (MPW), and the relationship between hormone replacement therapy (HTR) and NAFLD. Material and methods MPW were enrolled from April/2009 to April/2011. Those who had criteria to NAFLD were included in two groups: • Group 1 (G1) women who referred HRT use > 6 months. • Group 2 (G2) women that denied HRT use. NAFLD criteria: history of ethanol intake < 20 g/day; exclusion of other liver diseases; presence of hepatic steatosis on abdominal ultrasound. All volunteers performed clinical and laboratorial evaluation. ATP-III criteria were used to metabolic syndrome (MS) and HOMA-IR > 3.0 was considered insulin resistance (IR). Fischer’s exact test and independent t-test were used to compare frequencies and means respectively. Proportions of NAFLD between groups were calculated to estimate the odds ratio (OR). All p-values were two tailed and the significance level was set to < 0.05.