Objective To investigate the association between Helicobacter pylori (HP) infection and newly named "metabolic associated fatty liver disease (MAFLD)" and the value of HP infection combined with traditional risk factors in predicting MAFLD. Methods A retrospective analysis was performed for the clinical data of 350 patients who were admitted to Affiliated Hospital of Inner Mongolia University for the Nationalities and underwent carbon-13 urea breath test from January 2017 to December 2021, and according to whether fatty liver disease was diagnosed by abdominal ultrasound, they were divided into MAFLD group with 190 patients and non-fatty liver disease group with 160 patients. The independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The binary Logistic regression analysis was used to investigate the risk factors for MAFLD. Results Compared with the non-fatty liver disease group, the MAFLD group had significantly higher body mass index ( t =8.73, P < 0.05), systolic blood pressure ( Z =-3.67, P < 0.05), diastolic blood pressure ( Z =-3.62, P < 0.05), triglyceride ( Z =-8.93, P < 0.05), fasting blood glucose ( Z =-9.13, P < 0.05), aspartate aminotransferase ( Z =-2.03, P < 0.05), gamma-glutamyl transpeptidase ( Z =-8.56, P < 0.05), proportion of male patients ( χ 2 =12.09, P < 0.05), and proportion of patients with hypertension ( χ 2 =37.91, P < 0.05), diabetes ( χ 2 =73.62, P < 0.05), overweight/obesity ( χ 2 =42.82, P < 0.05), hypertriglyceridemia ( χ 2 =59.12, P < 0.05), or HP infection ( χ 2 =4.53, P < 0.05), as well as a significantly lower level of high-density lipoprotein cholesterol ( Z =-6.81, P < 0.05). The Logistic regression analysis showed that fasting blood glucose (odds ratio [ OR ]=1.255, 95% confidence interval [ CI ]: 1.091-1.445, P < 0.05), HP infection ( OR =1.899, 95% CI : 1.048-3.440, P < 0.05), hypertension ( OR =2.589, 95% CI : 1.468-4.567, P < 0.05), diabetes ( OR =2.202, 95% CI : 1.123-4.315, P < 0.05), overweight/obesity ( OR =4.571, 95% CI : 2.308-9.052, P < 0.05), and hypertriglyceridemia ( OR =4.187, 95% CI : 2.411-7.271, P < 0.05) were risk factors for MAFLD, and it also showed that HP infection combined with traditional risk factors significantly increased the risk of MAFLD in subjects with diabetes, overweight/obesity, hypertriglyceridemia, and hypertension ( OR =12.267, 14.005, 7.911, and 7.364, all P < 0.05). Conclusion HP infection is associated with an increased risk of MAFLD, and its combination with traditional risk factors may further increase the risk of MAFLD.