Coffee caffeine consumption (CC) is associated with reduced hepatic fibrosis in patients with chronic liver disease such as hepatitis C. The association of caffeine consumption with non-alcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to correlate CC with the prevalence and severity of NAFLD. Patients involved in a previously published NAFLD prevalence study as well as additional non-alcoholic steatohepatitis (NASH) patients identified in the Brooke Army Medical Center Hepatology clinic were queried about their caffeine intake. A validated questionnaire for CC was utilized to assess for a relationship between caffeine and 4 groups: US negative (controls), bland steatosis/not-NASH, NASH stage 0-1, and NASH stage 204. 306 patients responded to the CC questionnaire. Average milligrams of total caffeine/coffee CC per day in controls, bland steatosis/not-NASH, NASH stage 0-1, and NASH stage 2-4 were 307/228, 229/160, 351/255, and 252/152 respectively. When comparing the patients with bland steatosis/not-NASH to those with NASH stage 0-1, there was a significant difference in caffeine consumption between the two groups (p = 0.005). Additionally, when comparing the patients with NASH stage 0-1 to those with NASH stage 2-4, there was a significant difference in coffee CC (p = 0.016). Spearmans rank correlation analysis further supported a negative relationship between coffee CC and hepatic fibrosis (r = 0.215, p = 0.035). Conclusion: Coffee caffeine consumption is associated with a significant reduction in risk of fibrosis among NASH patients.