Background: Non-alcoholic steatohepatitis (NASH) operates as a disease path that damages the liver through tissue inflammation combined with fibrosis and relates to metabolic syndrome conditions. Research data indicates that H. pylori bacterial infection may play a role in advancing the development of NASH. Objective: The research explores the relationship between Helicobacter pylori infection and NASH through analysis of liver condition along with metabolic measurements and disease progression severity. An evaluation of this study analyzes how treating H. pylori infection affects liver function outcomes in patients who have NASH. Methods: This research included 100 subjects consisting of 50 patients with NASH and 50 subjects in healthy control status. A collection of serum H. pylori IgG antibodies with stool antigen tests examined H. pylori infection status. The analysis included liver function tests which measured ALT, AST, GGT, total bilirubin and albumin together with metabolic parameters for fasting glucose and HbA1c in addition to hs-CRP inflammatory markers. Liver fibrosis along with NASH severity received evaluation through FibroScan transient elastography and biopsy results that provided histological scores. A logistic regression analysis determined the independent relationship between H. pylori and NASH by assessing the direct connection between these variables. Results: The study revealed that H. pylori infection was present in 70% of NASH patients but only 40% of controls so the difference reached statistical significance (p=0.001). NASH patients who were positive for H. pylori infection demonstrated elevated blood test markers ALT, AST and GGT which signifies enhanced liver damage throughout the study (p<0.001). The metabolic health parameters fasting glucose and HbA1c and triglycerides reached elevated levels during bacterial testing for Helicobacter pylori in NASH patients (p<0.01). The presence of H. pylori infection produced enhanced hospital measures for liver fibrosis staging and elevated hs-CRP blood levels in study participants (p=0.0005 and p=0.001). Logistic regression analysis established that detecting H. pylori inside the body serves as an independent risk factor for developing NASH (OR: 2.8, 95% CI: 1.5-5.2, p=0.001). Medically eliminating H. pylori from NASH patients led to major improvements of liver enzymes and inflammatory biomarkers during six months of treatment (p<0.01). Conclusion: The research demonstrates a significant link between H. pylori infection and NASH which might lead to worse disease progression and impaired metabolic function. The removal of H. pylori shows promise to enhance liver function which could serve as an effective treatment approach for NASH patients.