Background Cissus quadrangularis L. is commonly known as hadjod and traditionally used as a medicinal plant for the treatment of osteoporosis, dyspepsia, tumors, chronic ulcers, and hepatic diseases. Existing studies have proclaimed the proinflammatory property of NOX4 through instigating ROS and oxidative stress, which is considered to be one of the instrumental causes of steatohepatitis. Purpose To investigate the protective effect of ethanolic extract of C. quadrangularis (EECQ) on the steatohepatitis associated with type 2 diabetes (DM) through inhibition of NOX4. Methods An experimental DM-induced steatohepatitis was developed by feeding a high-fat diet for 12 weeks in Sprague Dawley rats. Treatment of EECQ was given at a dose of 200 mg/kg (po), for six weeks. Glucose and insulin tolerance test was conducted. Hematoxylin and eosin and picrosirius red staining of liver sections was done. Steatosis and lobular inflammation were scored, and hepatocyte ballooning was assessed to confirm the NASH. qPCR, Immunofluorescence, and Immunoblotting determined the mRNA and protein expression of NOX4. Results NASH group rats manifested features of DM, marked by aggravated glucose and insulin tolerance tests. Moreover, the DM rats exhibited the presence of steatohepatitis, characterized by elevated serum lipid content, aminotransferases, and presence of steatosis, lobular inflammation, and ballooning in the liver section. Nevertheless, EECQ treatment prevented all of these abnormalities. Besides, the level of AGEs and the expression of its receptor, RAGE was found to be increased in DM rats. Parallelly, the expression of NOX4 and the accompanying level of ROS, oxidative stress markers, and inflammatory cytokines were determined to be surged in palmitic acid exposed HepG2 cells and DM rats. However, EECQ treatment exemplified safeguards from the soared level of the aforementioned markers. Conclusion Collectively, the above findings propounded the protective effect of EECQ against steatohepatitis. Nonetheless, further studies on humans necessitate to scrutinize and reinforce its therapeutic potential so that it may be employed as a remedy for DM-induced steatohepatitis.