Abstract: Objective：To explore the role of anthropometric indicators (body mass index, waist circumference, waist circumference height ratio, waist-to-hip ratio, etc.) in predicting the progression of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. Methods：A total of 535 consecutive patients with type 2 diabetes mellitus were enrolled, and demographic data, anthropometric indicators, and laboratory test data were collected. According to whether NAFLD presented or not, the patients were divided into the progression group and the non-progression group, and the clinical characteristics of the two groups were analyzed. The regression analysis was performed using the binary logistic regression model, and the test efficacy analysis was performed using the receiver operating characteristic curve (ROC). Results：Compared with the non-progression group (n=389), patients in fatty liver progression group (n=146) were younger, and the body mass index, waist circumference, waist circumference height ratio, waist-to-hip ratio, triglyceride, uric acid, alanine, and aspartate aminotransferase were significantly higher (P<0.05). The multiple regression analysis results showed that body mass index, waist circumference, waist circumference height ratio, waist-to-hip ratio were independent risk factors for the development of NAFLD in patients with type 2 diabetes respectively (P=0.000). ROC analysis showed that AUCs for body mass index, waist circumference, waist circumference height ratio, and waist-to-hip ratio were 0.675, 0.677, 0.664, and 0.642, respectively, and the best cut-off points for predicting NAFLD were 24.23 kg/m2, 93.5 cm, 0.57, and 0.89, respectively (P=0.000). Conclusions：Body mass index, waist circumference, waist circumference height ratio, and waist-to-hip ratio all can predict the progression of NAFLD in patients with type 2 diabetes.