Nonalcoholic fatty liver disease (NAFLD) has been thought to be associated with cardiovascular outcomes. A matched cohort study, including >18 million European adults, investigated the risk of acute myocardial infarction (AMI) or stroke in adults with NAFLD or nonalcoholic steatohepatitis (NASH). A diagnosis of NAFLD in routine care does not seem to be associated with risk of AMI or stroke after adjustment for established cardiovascular risk factors. The authors conclude that risk of cardiovascular disease should be assessed in the standard way in these patients, and that NAFLD should not be considered as a risk enhancer.