Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is associated with metabolic disorders. This study aimed to explore the role of metabolic disorders in screen-ing advanced fibrosis in NAFLD patients. Methods: A total of 246 histologically-proven NAFLD patients were enrolled across 14 centers. We compared the severity of fibrosis in patients with different components of metabolic disorders. Based on standard noninvasive tests and metabolic disor-ders, we developed new algorithms to identify advanced fi- brosis. Results: Metabolic syndrome (MetS) was frequent in NAFLD patients (133/246, 54％). Patients with MetS had a higher proportion of significant fibrosis (p=0.014) and higher LSM values (9.2 kPa, vs. 7.4 kPa, p=0.002) than those without MetS. Patients with more metabolic disor-ders had higher fibrosis stages (p=0.017). Reduced high-density lipoprotein cholesterol (odds ratio [OR]: 2.241, 95％ confidence interval [CI]: 1.004-5.002, p=0.049) and raised fasting glucose (OR: 4.500, 95％ CI: 2.083-9.725, p<0.001) were significantly associated with advanced fibro-sis. Using these two metabolic disorders as a screening tool, a sensitivity, specificity and accuracy of 92％, 81％ and 83％ was achieved, respectively. With the new algorithms com-bining metabolic disorders with noninvasive measurements, the number of patients requiring liver biopsy was reduced, especially in combination with the Fibrosis-4 score and met-abolic disorders (36％ to 17％, p<0.001). In addition, this stepwise algorithm could achieve a high accuracy (85％) and high negative predictive value (93％). Conclusions: Metabolic disorders should be taken into consideration in the diagnosis of advanced fibrosis. With further validation and investigation, new algorithms could be recommended in primary care units to spare patients from unnecessary referral and liver biopsies.