Background and Objectives: Experimental and observational studies suggest a role for increased uric acid in non-alcoholic fatty liver disease (NAFLD). This study aimed to systematically review the association between serum uric acid (SUA) levels and NAFLD. Method and Study Design: We used PubMed, and the EMBASE database to identify all applicable studies through November 2015. We used the weighted mean difference (WMD) to demonstrate the differences between the control and NAFLD groups in continuous data. We calculated the odds ratios (ORs) for dichotomous data using the Mantel-Haenszel method. A total of 16 observational studies were identified and used for the analysis of continuous data, and 4 studies were analyzed for dichotomous data. Results: The WMD was 52.3 (95% CI: 39.0, 65.5, p<0.00001). The pooled OR in observational studies was 2.08 (95% CI: 1.93-2.24, p<0.00001). The results were heterogeneous for the comparison of continuous data and homogeneous for the comparison of dichotomous data. The SUA cutoff value for the occurrence of NAFLD was 308, with a sensitivity of 94.12% [71.3-99.9] and specificity of 70.6% [44.0-89.7]. Conclusion: We observed a positive association between increased SUA levels and the diagnosis of NAFLD in all analyses. Our results suggest that SUA is upregulated in patients with NAFLD and might be related to the pathogenesis of NAFLD.