Non-alcoholic steatohepatitis (NASH), the progressive form of non-alcoholic fatty liver disease (NAFLD), is emerging as a main health problem in industrialized countries. Lifestyle modifications are effective in the treatment of NAFLD; however, the long-term compliance is low. Therefore, several pharmacological treatments have been proposed but none has shown significant efficacy or long-term safety. Natural polyphenols are a heterogeneous class of polyphenolic compounds contained in vegetables, which are being proposed for the treatment of different metabolic disorders. Although the beneficial effect of these compounds has traditionally related to their antioxidant properties, they also exert several beneficial effects on hepatic and extra-hepatic glucose and lipid homeostasis. Furthermore, natural polyphenols exert antifibrogenic and antitumoural effects in animal models, which appear relevant from a clinical point of view because of the association of NASH with cirrhosis and hepatocellular carcinoma. Several polyphenols, such anthocyanins, curcumin and resveratrol and those present in coffee, tea, soy are available in the diet and their consumption can be proposed as part of a healthy diet for the treatment of NAFLD. Other phenolic compounds, such as silymarin, are commonly consumed worldwide as nutraceuticals or food supplements. Natural antioxidants are reported to have beneficial effects in preclinical models of NAFLD and in pilot clinical trials, and thus need clinical evaluation. In this review, we summarize the existing evidence regarding the potential role of natural antioxidants in the treatment of NAFLD and examine possible future clinical applications.Keywords fibrosis -NASH -nutraceuticals -oxidative stress -polyphenols Abbreviations ACC, acetyl coenzyme A carboxylase; ACN, anthocyanins; AKT, serine-threonine protein kinase; AMPK, adenosine monophosphate-activated protein kinase; CD36, cluster of differentiation 36; CHREBP, carbohydrate-responsive element-binding protein; COX-2, cyclooxygenase 2; CYP2E1, cytochrome P450 2E1; CYP4A1, cytochrome P450 4A1; DJ-1, protein deglycase-1; EC-SOD, extracellular superoxide dismutase; EGCG, epigallocatechin gallate; ERK, extracellular receptor kinase; FA, fatty acid; FAS, fatty acid synthase; FFA, free fatty acid; GGT, gamma glutamyl transferase; GRP-78, 78 kDa glucose-regulated protein; GSH, glutathione; HDL, high density lipoprotein; HFD, high fat diet; HMG-CoA, 3-Hydroxy-3-Methyl-Glutaryl-CoA; HSC, hepatic stellate cell; ICAM-1, intercellular cell adhesion molecule type 1; IRS-1, insulin receptor substrate-1; JNK, Jun Nterminal kinase; LDL, low density lipoprotein; MCP-1, monocyte chemoattractant protein-1; NAD, nicotinamide adenine dinucleotide; NAFLD, nonalcoholic fatty liver disease; NASH, nonalcoholic steatohepatitis; NFkB, nuclear factor kappa B; NRF2, nuclear respiratory factor 2; PDGF-BB, platelet-derived growth factor-BB; PGC-1a, proliferator-activated receptor-gamma coactivator-1alpha; PI3K, phosphoinositide 3-kinase; PPAR-a, peroxisome pro...