Abstract: INTRODUCTION: This study investigated the prevalence and risk factors of metabolic-associated fatty liver disease (MAFLD) in the Korean Air Force population (2020-2022), comparing nonpilot and pilot groups. METHODS: Participants over 40 yr were classified into MAFLD or non-MAFLD groups. MAFLD was defined as hepatic steatosis on ultrasonography plus one of the following: overweight/obesity, type II diabetes, or metabolic deregulations. Variables analyzed included body mass index (BMI), alanine aminotransferase (ALT), uric acid, fasting plasma glucose, lipid profile, triglycerides, albumin, and exercise habits. RESULTS: Among 1044 participants (667 pilots, 377 nonpilots), MAFLD prevalence was 30.3%, significantly lower in pilots (27.7%) than in nonpilots (34.7%). For nonpilots, BMI [odds ratio (OR) = 3.41], diabetes (OR = 8.32), and ALT (OR = 1.91) were significant factors, although the small sample size limited broader conclusions. Among pilots, BMI (OR = 3.77), uric acid (OR = 1.83), ALT (OR = 1.98), triglycerides (OR = 1.50), and dyslipidemia (OR = 7.97) were strongly associated with MAFLD. Uric acid levels had a greater association with MAFLD in pilots compared to nonpilots. DISCUSSION: This study highlights the distinct prevalence and risk factors of MAFLD in pilots vs. nonpilots. Uric acid, in particular, emerged as a significant risk factor for pilots, suggesting its potential use for targeted risk assessment in this group. The findings underscore the importance of tailored preventive strategies for MAFLD in occupational groups.