Purpose: The purpose of this study was to evaluate the effectiveness of exercise combined with health literacy training on liver fat grade and body mass index in sedentary middle-aged men. Methods: This quasi-experimental study was a pretest-posttest with a control group. 22 sedentary middle-aged man with a liver grade higher than 1 were purposefully selected and randomly divided into intervention (n = 11) and control (n = 11) groups. The subjects in the intervention group participated in the exercise training protocol for 8 weeks along with the health literacy training program, the control group did not have any intervention. Data were collected through liver ultrasound, blood sampling and body mass index measurement before and after the intervention and analyzed using ANCOVA test and SPSS20 software. Results: The results showed that exercise along with health literacy training improves liver fat content and reduces body mass index in the experimental group compared to the control group (P <0% 5). Conclusion: This study showed that performing two interventions of exercise and health literacy simultaneously is effective in improving the fat content of the liver and body mass index of sedentary middle-aged men and prevents the development of advanced fatty liver.