Objective:To analyze the clinical characteristics of pancreatic fatty infiltration in the Tibetan population in Xizang and investigate the factors influencing pancreatic fatty infiltration.Methods:A case-control study was performed to retrospectively analyze the clinical data of 103 Tibetan patients diagnosed with pancreatic fatty infiltration through imaging examinations at the People's Hospital of Xizang Autonomous Region between January 2013 and December 2023 (patient group). Additionally, 103 Tibetan patients who were not diagnosed with pancreatic fatty infiltration during the same period at the same hospital were randomly selected and included in the control group. The clinical indicators were compared between the two groups.Results:The male-to-female ratio among the 103 Tibetan patients with pancreatic fatty infiltration was approximately 1:0.6. The average age of onset was (63.14 ± 13.95) years, and the predominant occupation was public officials, accounting for 54 cases (52.94%). The differences in age, occupation, and the presence of non-alcoholic fatty liver, chronic gastritis, gallbladder stones, cholecystitis, diabetes mellitus, hyperlipidemia, atherosclerosis, hypertension, hyperuricemia, and obesity, as well as clinical symptoms between the two groups, were statistically significant (all P < 0.05). Multivariate logistic regression analysis showed that age ( OR = 4.87, P = 0.010) and obesity ( OR = 20.90, P = 0.049) were independent risk factors for pancreatic fatty infiltration, while being a farmer ( OR = 0.05, P < 0.001) was a protective factor against pancreatic fatty infiltration. Conclusion:Pancreatic fatty infiltration is more common in men than in women and is primarily observed in middle-aged and older adult public officials. Age and obesity are independent risk factors for pancreatic fatty infiltration, while being a farmer is a protective factor compared with other occupations.