Background: Diagnosed of nonalcoholic steatohepatitis (NASH) is primarily relied on histopathologic examination, which is an invasive process however a noninvasive surrogate markers are preferred for screening of patients who are at high risk of NASH. Attenuation coefficient, dispersion slope and shear-wave speed are Ultrasonographic parameters that assist in estimating inflammation, steatosis and fibrosis and might enable the noninvasive diagnosis of nonalcoholic steatohepatitis within a single examination. Aim: To evaluate the diagnostic efficacy of attenuation coefficient, dispersion slope and shear-wave speed measurements obtained through two-dimensional (2D) shear-wave elastography (SWE) in evaluating fibrosis, inflammation and steatosis as well as in the noninvasive diagnosis of NASH in individuals suspected of suffering from nonalcoholic fatty liver disease (NAFLD). Materials and Methods: This prospective analytical study gathered information from 200 consecutive adult patients who have gone for liver biopsy due to suspected NAFLD and were included between January 2021 and December 2023. Three ultrasonographic parameters [attenuation coefficient (dB/cm/MHz), dispersion slope (m/sec/kHz), and shear-wave speed (in meters per second)] were measured using a 2D shear-wave elastography (SWE) system right before the biopsy. The biopsy specimens were evaluated by an expert pathologist bases on the Nonalcoholic Steatohepatitis Clinical Research Network criteria. Diagnostic efficacy was determined using the area under the receiver operating characteristic curve (AUC) for the aspect of steatosis and fibrosis. Results: All the recorded data were checked at initial stages for presence of any obvious integrated confounders. Post hoc analysis was not attempted so as to ensure data quality with minimal errors. Afterward data was subjected to basic statistical analysis with SPSS statistical package for the Social Sciences version 22 for Windows. Total of 188 adult individuals were selected including both male and female patients. The mean values for age and body mass index were 56 years ±14 and 28. 3 kg/sqm ±5.7 respectively. The AUC of dispersion slope was 0.77 (95% CI: 0.64, 0.89), the AUC of attenuation coefficient was 0.72 (95% CI: 0.59, 0.84), the AUC of shear wave speed was 0.71 (95% CI: 0.59, 0.84), and the AUC of the all three parameters combinedly was 0.82 (95% CI: 0.73, 0.91). When comparing assessment of fibrosis using shear-wave speed, there were significantly differences in shear-wave speed across fibrosis stages f0, f1, f2, f3, and f4 Conclusion: Attenuation coefficient, dispersion slope and shear-wave speed were determined to be beneficial for evaluating lobular inflammation, steatosis, and fibrosis, respectively, in individuals with biopsy confirmed nonalcoholic fatty liver disease (NAFLD).