Background: Obesity is a chronic disease that is increasing in prevalence worldwide leading to much co-morbidity and even pre-mature death, additionally the leading predisposing factor for none-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). NASH is usually associated with increased risks of cirrhosis, liver failure, hepatocellular carcinoma, and the need for liver transplantation. Bariatric surgery is one of definitive solution for obesity; however, sleeve gastrectomy (SG) is the most common types of bariatric surgeries performed worldwide. Here, we investigated the use of a bariatric surgery in reversing the inflammation and liver damage associated with NAFLD/NASH and thus alleviating the patients' need for future liver transplantation. Patients and Methods: 184 patients enrolled randomizely in the study, all of them had NAFLD diagnosed by 2 dimensional ultrasound (US) and or computed tomography (CT), 156 NAFLD patients treated with ELBANNA bypass operation, however 28 patients (control Group) treated with Sleeve gastrectomy. Results: All 156 patients experienced Elbanna operation, significantly reversed NAFLD pattern in 118 (75.6 %), 131 (83.9 %), and 152 (97.4 %), 12, 24 and 36 months after ELBANNA operation, respectively. By contrast, among 28 NAFLD control patients, only 7 patients (25%) showed improved liver condition, 36 months after standard bariatric sleeve gastrectomy. P-Value is < .00001. Conclusion: Bariatric bypass operation would be highly recommended for obese patients who developed NAFLD/NASH to avoid further decompensation of the liver and alleviating the future need of liver transplantation and its complications.