The article presents the features of the course of non-alcoholic fatty liver disease in obese patients, the mechanisms of this pathology and the impact of this condition during pregnancy. Much attention is paid to disorders of fat metabolism, which contribute to a complicated course of gestation, increasing the possibility of development of placental insufficiency, miscarriages, preeclampsia and generally have a negative impact on perinatal outcomes. Modern diagnostics and correction of these disorders are discussed.