Background and aim: Little is known about that the relationship between hepatic fat content (HFC) and metabolic syndrome (MetS). We aimed to determine whether HFC correlated with MetS in patients with nonalcoholic fatty liver disease (NAFLD). Methods: HFC was measured by MRI-determined proton density fat fraction (MRI-PDFF) for 131 suspected NAFLD subjects. Patients with NAFLD defined as MRI-PDFF >= 5% were stratified into two groups based on whether they were above or below the median MRI-PDFF value; the MRI-PDFF value for the control group was <5%. The primary outcome was the presence of MetS. Logistic regression models were used to obtain the associations between the severity of liver fat and MetS, and the corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were recorded. Results: Compared to NAFLD patients with low-HFC (n = 48) and the control group (n = 35), NAFLD patients with high-HFC (n = 48) had significantly greater prevalence of central obesity, hypertension, hyperglycemia, and hypertriglyceridemia (all P < 0.05). NAFLD patients with high-HFC had a higher prevalence of MetS than NAFLD patients with low-HFC (79.2% vs. 56.2%, P < 0.05). The multivariate-adjusted OR for the prevalence of MetS comparing NAFLD patient with low-HFC and high-HFC to the control group were 4.56 (95% CI: 0.54-38.79, P = 0.165) and 22.91 (95% CI: 1.80-292.21, P = 0.016), respectively (P-trend = 0.014). Conclusion: Increased hepatic fat quantitatively measured by MRI-PDFF had a significant dose-relationship with the presence of MetS, and the amount of liver fat may affect cardiovascular risk.