Introduction: Fatty liver is a global pandemic and is recognized as one of the most important etiology for liver cirrhosis and hepatocellular carcinoma across the world. While lifestyle modification remains the cornerstone for fatty liver management, drugs are also gradually becoming available to address the issue.

Materials & Methods: We recruited 52 patients diagnosed as having fatty liver in this prospective, real-life study. They were randomized into two groups. Saroglitazar group had 30 patients who were prescribed generic saroglitazar 4 mg orally, daily and lifestyle modification. The control group included 20 fatty liver patients, who were advised only lifestyle modification. Patients were followed up at 6 months. Serum alanine aminotransferase and aspartate aminotransferase levels, ultrasonography of hepatobiliary system and Fibroscan were checked at baseline and repeated at 6 months.

Results: We observed significant reduction in hepatic fat content as well as improvement in liver enzymes in the saroglitazar group compared to the control group. Reduction in hepatic fibrosis was also seen, but it was not statistically significant.

Conclusion: Our real-life study shows promising results with generic saroglitazar in fatty liver patients, justifying the need for larger clinical trials.