Objective To  investigate  the clinical  features and  related  risk  factors of  fatty  liver disease  in Zaozhuang area  in Shandong province. Methods All of 1086  subjects  in Zaozhuang area  in Shandong province who had health examination in our hospital from 2003 to 2009. Total of 318 patients were diagnosed as  fatty  liver  and 768 healthy  adults were  taken  as  control. They were  compared with demographic, biochemical  and metabolic  characteristics. Retrospective  case-control  study was done  to  explore  the clinical  features and prevalence of  fatty  liver with Logistic  regression analysis. Results The patients with fatty  liver account  for 29.77%  in  the population who had health examination, and  the percentage of male patients  (17.88%) was significantly higher  than  female patients  (13.20%). There were statistic difference between patients with  fatty  liver and healthy controls  in TG, HDLC and FPG. Logistic  regression analysis demonstrated that the prevalence of fatty liver was positively correlated to factors including male, drink and obesity. Conclusions Male, drink and obesity may be independent risk factors to fatty liver. To prevent fatty liver and related syndromes, changing bad life styles, periodical physical examination and obesity controlling may be the major measures.