Background: Lifestyle modification is recognized as the first step of fatty liver treatment. This study was done to determine the relationship between the awareness of the Non-Alcoholic Fatty Liver Disease (NAFLD) and adolescents’ health-promoting lifestyle in senior high school students in the west of Tehran, Iran. 
Methods: This descriptive-correlational study was performed on 338 high school students in 2020. The students were recruited by cluster sampling method. The data were collected by demographic information form, awareness of non-alcoholic fatty liver questionnaire, and Health-Promoting Lifestyle Profile II (HPLPII) and were expressed using frequency, mean, standard deviation, and analyzed by inferential statistical tests of ANOVA, Chi-square, independent t-test, and Pearson correlation coefficient using SPSS 20.
Results: The results showed that the highest Mean±SD of health-promoting lifestyle was related to spiritual growth and self-actualization dimension (27.41±5.53) and the lowest Mean±SD was related to the dimension of physical activity (19.71±6.63). There was a significant relationship between awareness of NAFLD and the health responsibility subscale of HPLP (P=0.004). Awareness of NAFLD had a direct relationship with the father’s education (P=0.004). The health-promoting lifestyle was positively related to students’ grade (P<0.001), birth order (P=0.019), economic status (P<0.001), number of children (P=0.037), and living with parents (P=0.031), and negatively associated with the students’ age (P=0.014). 
Conclusion: The significant relationship between knowledge about fatty liver and health responsibility indicates the need to increase students’ awareness of this disease to improve a health-promoting lifestyle. Therefore, it is suggested that educational interventions be provided at different levels of prevention to empower students.

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