AIM: To investigate the relationship between cholecystectomy and fatty liver disease(FLD) in a Chinese population.METHODS: A total of 32428 subjects who had voluntarily undergone annual health checkups in the Second Affiliated Hospital of Nanjing Medical University from January 2011 to May 2013 were included in this study. Basic data collection, physical examination, laboratory examination, and abdominal ultrasound examination were performed.RESULTS: Subjects undergoing cholecystectomy were associated with greater age, female sex, higher body mass index, and higher levels of systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, and triglycerides. However, no significant differences were found in high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, gammaglutamyl transpeptidase, albumin, and serum uric acid. The overall prevalence of FLD diagnosed by ultrasonography was high at 38.4%. The prevalence of FLD was significantly higher for subjects who had undergone cholecystectomy(46.9%) than those who had not undergone cholecystectomy(38.1%; χ2 test, P < 0.001). Cholecystectomy was positively associated with FLD(OR = 1.433, 95%CI: 1.259-1.631). However, after adjusting for possible factors associated withFLD, multivariate regression analysis showed that the association between cholecystectomy and FLD was not statistically significant(OR = 1.096; 95%CI: 0.939-1.279). CONCLUSION: According to our study results, cholecystectomy may not be a significant risk factor for FLD. A to investigate the relationship between cholecystectomy and fatty liver disease (FLD) in a Chinese population. METHODS: A total of 32428 subjects who had voluntarily undergone annual health checkups in the Second Affiliated Hospital of Nanjing Medical University from January 2011 to May 2013 were Basic data collection, physical examination, laboratory examination, and abdominal ultrasound examination were performed .RESULTS: Subjects undergoing cholecystectomy were associated with greater age, female sex, higher body mass index, and higher levels of systolic blood pressure, diastolic Blood pressure, fasting plasma glucose, total cholesterol, and triglycerides. However, no significant differences were found in high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, gammaglutamyl transpeptidase, albumin, and serum uric acid. overall prevalence of FLD diagnosed by ultrasonography was hig h at 38.4%. The prevalence of FLD was significantly higher for those who had undergone cholecystectomy (46.9%) than those who had not undergone cholecystectomy (38.1%; χ2 test, P <0.001). Cholecystectomy was positively associated with FLD 1.433, 95% CI: 1.259-1.631). However, after adjusting for possible factors associated withFLD, multivariate regression analysis showed that the association between cholecystectomy and FLD was not substantially significant (OR = 1.096; 95% CI: 0.939-1.279). CONCLUSION: According to our study results, cholecystectomy may not be a significant risk factor for FLD.