OBJECTIVE: To observe the therapeutic effect of Chinese herbal recipe Zhifang I Decoction on nonalcoholic fatty liver disease (NAFLD) complicating hyperuricemia (HUA). METHODS: Forty-six patients suffering from NAFLD complicating HUA were randomly divided into treatment group (25 cases) with Zhifang I and control group (21 cases) with Xuezhikang Capsule. One course of treatment was 8 weeks. The data were processed by SPSS 11.0 statistical package after 2 courses of treatment. RESULTS: The total effective rate of the treatment group was 80.00%, which surpassed the control group (71.43%) (P<0.01); Zhifang I could improve the image of B-mode ultrasonography and was better than Xuezhikang in ameliorating the clinical symptoms (P<0.05); Zhifang I could significantly decrease the serum uric acid (UA) (P<0.01), while Xuezhikang had no obvious therapeutic effect on it (P>0.05); Zhifang I was as good as Xuezhikang in recovering alanine aminotransferase (ALT), aspartate aminotransferase (AST),gamma-glutamyltransferase (gamma-GT), total cholesterol (TC) and triglyceride (TG) (P>0.05). CONCLUSION: Zhifang I has good effect in treating NAFLD complicating HUA.