Purpose: To evaluate the ARFI technique in non-invasive diagnosis and quantification of NAFLD in MS patients. Methods: A total of 201 type 2 diabetes mellitus (T2DM). patients undergoing normal liver Doppler ultrasound examination were enrolled in the study (95 with NAFLD and 106 without NAFLD). 56 patients (out of 95) in the NAFLD group were diagnosed with hepatic insufficiency (NAFLD-HI) and the remaining 39 patients in the NAFLD group had normal liver functions (NAFLD-normal), according to the blood biochemical parameters, physical exam and patient history. The liver elasticity of all MS patients was measured using the ARFI technique. The ARFI parameters for the NAFLD group and non-NAFLD group, as well as the NAFLD-HI group and the NAFLD-normal group were analyzed and compared.Results: The ARFI parameters for the NAFLD group is significantly lower than the non-NAFLD group among MS patients (p<0.01). The ARFI parameters for patients in the NAFLD-HI group are significantly higher than patients in the NAFLD-normal group (p=0.022). The area under the receiver-operator curve (ROC) for classifying NAFLD and non-NAFLD groups using ARFI parameter values is 0.745 (95% confidence interval 0.616~0.814). The sensitivity and specificity at the optimal cut-off point on ROC (1.06 m/s) are 88.7% and 45.7% respectively. The ARFI values were found to be correlated with triglyceride level and body mass index for the NAFLD patient group.Conclusions: The ARFI technique is capable of non-invasive assessing and detecting the NAFLD in T2DM patients in clinic practice.