Non-alcoholic fatty liver disease (NAFLD) comprises a heterogeneous group of metabolic liver diseases and is characterized by the presence of steatosis in at least 5% of hepatocytes. The aim of our study was to assess the effect of the combination therapy of empagliflozin + metformin vs metformin monotherapy on NAFLD progression in type 2 diabetic (T2DM) patients. Sixty-three metformin-treated T2DM patients who were SGLT2i-naive and had an ultrasound diagnosis of NAFLD (aged 60.95±11.14 years; males, 57.1%) were included in the present analysis. Thirty-three started the combination therapy. All patients were observed for 6 months and routinely monitored with anthropometry, blood biochemistry, and FibroScan®/CAP. At the 6-month follow-up, the combination therapy group presented a significant reduction in BMI (30.83±3.5 vs 28.48±3.25), glycated hemoglobin (8.2 (7.4-8.8)) vs 7.2 (6.8-7.9), ALT (68.5 (41.5-88.0) vs 45.00 (38.00, 48.00)), CAP parameter (293.5 (270.0-319.25) vs 267.00 (259.50, 283.75)) and steatosis degree (p=0.001) in comparison with the control group, whose parameters remained almost stable over time. In patients affected by T2DM, the combination of empagliflozin + metformin vs metformin monotherapy ameliorated liver steatosis, ALT levels, body weight, and glycated hemoglobin after a 6-month follow-up.