Background: Evidence on the effect of cooking oil fumes exposure on fatty liver disease (FLD) is limited.Our study aimed to investigate the association between exposure to the fumes of cooking oil and the risk of FLD.Methods: A total of 55,959 participants aged 40-75 years old participated in a community-based survey in Ningbo, China. Information on exposure to cooking oil fumes and FLD were collected by face-to-face interviews. Stratified analysis was performed, and participants were divided into 2 groups according to gender. Multiple logistic regression analyses were conducted to investigate the association between exposure to cooking oil fumes and the risk of FDL. Furthermore, ordered logistic regression analysis was conducted to investigate the association between cooking oil fume exposure and the severity of FLD.Results: The prevalence of FLD was 8.79% in the no oil fume exposure group, 10.52% in the light oil fume exposure group, 23.47% in the moderate oil fume exposure group, and 41.45% in the heavy oil fume exposure group. After adjusting for confounding factors, participants in the light, moderate, and heavy cooking oil fume exposure groups all had significantly higher odds ratios (ORs) as compared with participants in the no oil fume exposure group. In addition, an interaction effect between cooking oil fume exposure and gender on the prevalence and severity of FLD was observed. Females with heavy oil fume exposure had the highest ORs of FLD and extent of disease severity. In the stratified analysis, compared to participants in the fumeless group, males and females in the light, moderate, and heavy cooking oil fume exposure groups all had significantly higher risks of FLD and more severe extent of disease, while participants with heavier cooking oil fume exposure tended to have higher risk of FLD and more severe extent of disease.Conclusions: Exposure to the fumes of cooking oil is associated with the incidence and severity of FLD in 40-75 years old Chinese people. The associations might be dose-responsive. In addition, heavy exposure to oil fumes and the female gender might have a synergistic effect on the incidence and severity of FLD.