Lmesartan, an FDA-approved angiotensin II receptor blocker (ARB), is utilized to address hypertension. It can be employed independently or in conjunction with other antihypertensive medications. In the absence of comorbidities like chronic kidney disease, cerebrovascular events, heart failure, diabetes, and ischemic heart disease, Olmesartan, along with other ARBs, may serve as monotherapy for hypertension . Olmesartan is generally well-tolerated with few side effects. However, Olmesartan-induced enteropathy was initially documented in 2012 through a case series involving 22 patients. Subsequently, additional cases linked to Olmesartan and other angiotensin II receptor blockers (ARBs) such as irbesartan, valsartan, and telmisartan have been reported .The majority of cases are characterized by celiac sprue-like villous atrophy upon intestinal biopsy. The precise pathogenic mechanism remains undetermined, but a potential explanation suggests the inhibition of the intestinal immune suppressive effect of transforming growth factor-beta (TGF-β). This inhibition could lead to an increase in intestinal T-cell inflammation, resulting in cellular damage and malabsorption. Due to a lack of awareness regarding this condition, there is a tendency for underdiagnosis and the excessive utilization of healthcare resources. This can lead to unnecessary patient suffering, including hospital admissions for a condition that typically improves upon discontinuation of the causative drug. Increased awareness is crucial to prevent these adverse outcomes and ensure appropriate management. The Medline, Pubmed, Embase, NCBI, and Cochrane databases were searched for studies of patients with non-alcoholic fatty liver disease. Incidence, etiology, and management options were analyzed. An association between olmesartan and sprue-like enteropathy has been observed in several case series and reports.