Fetuin-A, also named as Alpha2-HS glycoprotein (AHSG), is a member of cystatin superfamily of protease inhibitors. It is a highly expressed glycoprotein in various fetal tissues whereas it is mainly expressed by the liver in adults. Fetuin A, an extracellular inhibitor of transforming growth factor β, is a profibrogenic stimulus in liver disease. Circulating fetuin-A may be a beneficial serum biomarker in the detection of liver and vascular fibrosis progression in patients with non-alcoholic fatty liver disease. It is also involved in several functions, such as endocytosis, brain development and the formation of bone tissue. Fetuin-A exerts its effects on the cardiovascular system by two different mechanisms.