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Objective This study aimed to assess the association between lipid accumulation product (LAP) index, a novel index combining waist circumference (WC) and triglyceride levels, and anthropometric indices, metabolic factors and hepatic function markers in obese subjects with non-alcoholic fatty liver disease (NAFLD).Design Cross-sectional study.Setting Specialised and subspecialised outpatient clinics of Tabriz University of Medical Sciences.Participants Overall, 232 adult patients with obesity and ultrasound-proven NAFLD were included in the present study.Outcome measures Anthropometric measurements (body weight, height and waist and hip circumferences) were measured, and serum levels of glucose, lipid profile, ferritin and liver enzymes were assessed subsequent to an overnight fasting.Results Mild and Moderate NAFLD were found in 43.5% and 48.2% of the participants, respectively. LAP index markedly increased with higher grades of steatosis, showing values of 63.72±22.26, 84.57±44.96 and 112.14±56.97 for healthy, grade I and grade II groups, respectively (p<0.001). There were significant differences in body weight (p=0.003), WC (p<0.001), fasting blood sugar (FBS) (p=0.004) and lipid profile (p<0.001) among LAP index quartiles. Moreover, the LAP index was positively correlated with body weight, liver function and, as expected, with lipid profile in all of the subjects with NAFLD. Sex differences showed an additional marked association of LAP with FBS (r=0.363 and p<0.001, respectively) and glycosylated haemoglobin (r=0.321 and p=0.002, respectively) in males and serum aspartate aminotransferase levels in females (r=0.223 and p=0.009, respectively).Conclusions In conclusion, the LAP index was not only associated with anthropometric indices, metabolic parameters and hepatic function markers, but also increased in line with higher grades of liver steatosis in NAFLD.