The insulin resistance-associated hepatic iron overload is the first aetiology of iron overload disorders in France. If we do not know its mechanism, the prevalence among type II diabetic patients is around 40%. Hyperferritinaemia is present in all cases, but is not specific of the diagnosis. This pathology features liver fibrosis among 10% of the patients and some cases of primary liver cancer have been described. Moreover, a large body of evidence favors the direct involvement of iron in the development of extra hepatic neoplasia, while therapeutic phlebotomy to maintain low to normal body iron stores can prevent all known complications of insulin resistance-associated hepatic iron overload. In addition, treatment of type II diabetes mellitus and other features of insulin resistance syndrome is essential. In conclusion, it is important to detect this syndrome during type II diabetes mellitus.