Abstract: AIM: To explore the associated factors between essential hypertension (EH) and nonalcoholic fatty liver (NAFLD) in elderly patients. METHODS: Ninety elderly hypertensive patients were divided into two groups: EH co-existing with NAFLD group (n=40) and group of patients with EH without NAFLD (n=50). Body mass index (BMI), waist/hip ratio (WHR), total cholesterol (TC), triglycerides (TG), C-reactive protein (CRP), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr) and fasting plasma glucose (FPG) were compared between groups and logistic regression was analyzed. RESULTS: In the group of EH co-existing with NAFLD, levels of BMI (26.8±2.3 vs.22.6±2.4, P<0.01), WHR (0.96±0.03 vs. 0.91±0.04, P<0.01), TG ［(2.6±0.4) mmol/L vs.(2.0±0.5) mmol/L, P<0.01］, ALT ［(31±8) mmol/L vs.(26±7) mmol/L, P<0.05］, AST ［(28±7) mmol/L vs.(24±7) mmol/L, P<0.05］, and FPG ［(5.2±0.8) mmol/L vs.(4.8±0.7) mmol/L, P<0.01］ were higher than in the EH without NAFLD group, whereas HDL-C ［(1.5±0.3) mmol/L vs.(1.7±0.4) mmol/L, P<0.01］ was lower than in the EH without NAFLD group. Logistic regression showed that BMI (P<0.01), WHR (P<0.01) and TG (P<0.01) were independent factors. CONCLUSION: BMI, WHR and TG are independent factors of EH co-existing with NAFLD in elderly patients.