Abstract: Objective To investigate the prevalence and major risk factors of fatty liver among the general population in rural area of Guangdong province.Methods 2 043 residents aged 7 years and above were selected by mult-istage sampling in Guangdong province.Questionnaire about smoking,alcohol consumption,diet,physical examination,liver ultrasonography and ser ological tests were carried out.Results A total of 264 residents were detected with fatty liver which prevalence was 12.9%(male 13.7%,female 12.5%),the prevalence of alcoholic fatty liver,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.5%,1.3% and 11.1% respectively.The prevalence of fatty liver was increased with the age in males and females.Among participants younger than 50 years old,the prevalence of fatty liver in males was significantly higher than that in females(χ²=13.985,P<0.001).The prevalence of fatty liver in children(7~18 years old)was 1.4%(5/367),all of them were nonalcoholic fatty liver,while the prevalence of fatty liver in adults was 15.5%,the prevalence of alcoholic fatty liver,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.66%,1.61% and 13.19% respectively.After being adjust ed for age and sex,the standar dized prevalence of fatty liver in 7 years and above was 10.54%,the standardized prevalence of alcoholic fatty liver,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.55%,1.52% and 8.34% respectively.The standar dized prevalence of fatty liver in adults was 13.81%,the standardized prevalence of alcoholic fatty liver,suspected alcoholic fatty liver and nonalcoholic fatty liver were 0.74%,2.1% and 10.95% respectively.Risk factors associated with fatty liver in rural adults of Guangdong province with single variate analysis demonstrated that risk factors such as the age,sex,education level,dr inking,diet,body mass index(BMI),waist circumference(WC),waisthipratio(WHR),blood pressure,fasting serum glucose,triglyceride(TG),total cholesterol(TC),high-and low-density lipoprotein cholesterol level were related to fatty liver.Logistic regression analysis demonstrated that female,educational level were protective factors of fatty liver while risk factors such as drinking,salty favor,BMI,WC,WHR,TG,fasting serum glucose and hyper tension were positively correlated to fatty liver.Conclusion The major type of fatty liver in rural area of Guangdong province is non-alcoholic fatty liver,alcoholic consumption,diet and metabolic disorders are closely associated with fatty liver in rural adults of Guangdong province.