After synthesizing data from 36 studies published worldwide (n = 5021 PCOS patients), two key points can be extracted: (1) the burden of NAFLD in PCOS patients is concerning, with an estimated pooled prevalence of 43% (95% CI, 35–52%); (2) obesity (BMI and waist circumference), metabolic abnormalities (HOMA-IR, ALT, and triglycerides), and PCOS specific hallmarks (hyperandrogenism and free androgen index) were identified as risk factors for NAFLD in PCOS populations. This evidence concerns the gene GPT and polycystic ovary syndrome.