The lack of available organs for liver transplantation (LT) associated with the increased death rates among patients on the waiting lists for LT has triggered the use of so-called extended criteria donor (ECD) grafts. Among the wide range of these ECD livers, hepatic steatosis is one of the most frequent disorders, which is mostly related to an increasing prevalence of non-alcoholic fatty liver disease (NAFLD). NAFLD is increasingly significant in healthy individuals for its high worldwide prevalence, an association with the metabolic syndrome, such as insulin resistance, diabetes, dyslipidemia and obesity, and an association with liver-related morbidity and mortality. Using the ECD grafts especially those with NAFLD will markedly increase the donor pool for LT. Several approaches, including long-term and short-term measures, were identified for the management of NAFLD.