Silymarin (SIL) is an active extraction of the silybum marianum, milk thistle, which is an ancient medicinal plant for treatment of various liver diseases for centuries ⁽¹⁾. In this study, the authors assessed the therapeutic effect of SIL in the treatment of nonalcoholic fatty liver disease (NAFLD) through meta-analysis. Eight RCTs involved 587 patients were included in this study. The results showed that SIL reduced the AST and ALT levels more significantly than the control group. Compared with other interventions, there were significant differences decreasing AST and ALT levels when SIL was used alone. The authors conclude that SIL has positive efficacy to reduce transaminases levels in NAFLD patients. SIL can be an encouraging and considerable phytotherapy for NAFLD patients.