Objective: NAFLD (Nonalcoholic fatty liver disease) has been considered as a manifestation of metabolic syndrome. Lipoprotein(a) [Lp(a)] is well known for an independent risk factor for cardiovascular disease, and attract attention as a promising biomarker for metabolic diseases. However, whether Lp (a) is related to NAFLD is unknown. Thus, the aim of our study was to investigate the association between serum Lp (a) and NAFLD among nondiabetic Korean adults. Methods: Data were analyzed from 2242 nondiabetic Korean adults who underwent health screening examination. Anthropometric profiles were measured according to a standardized protocol. Fasting plasma glucose (FPG), insulin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT), lipids (triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], and total cholesterol [TC]) and lipoproteins (Apolipoprotien B [Apo B], Apolipoprotien AI [Apo AI], Lp(a)) were measured. Insulin resistance was estimated based on the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Diagnosis of fatty liver disease was based on an abdominal ultrasonography and NAFLD was classified into three groups according to severity. Results: BMI, SBP, DBP, FPG, TC, TG, LDL-C, Apo B, Apo AI, AST, ALT, insulin and HOMA-IR increased according to the severity of NAFLD, whereas HDL-C and Lp(a) levels decreased. And we found that the prevalence of NAFLD significantly decreased across Lp(a) tertiles. Also BMI, FPG, TG, insulin and HOMA-IR decreased with Lp(a) levels. In age and sex adjusted multivariable logistic regression analysis, Lp(a) level had decreased odds ratio (ORs) for the presence of NAFLD. The inverse relationship remained significant, even after adjusting for metabolic risk factors (ORs: II = 0.84, III = 0.63; 95% CI: II = 0.62~1.13, III = 0.26~0.86, respectively, P < 0.01), but this association was attenuated after adjustment for insulin resistance. (ORs: II = 1.00, III = 0.78; 95% CI: II = 0.68~1.42, III = 0.54~1.13, respectively, P = 0.33) Conclusion: Our results indicated that Lp(a) concentration was associated inversely with factors of metabolic syndrome and NAFLD in nondiabetic Korean adults.