Objective To study the association between sleep quality and metabolically associated fatty liver disease (MAFLD) in the physical examination population, and to explore the influencing factors of MAFLD. Methods From March 2024 to April 2024, 142 people who received the assessment of the Pittsburgh Sleep Quality Index (PSQI) and physical examination in the physical examination center of a tertiary hospital in Urumqi, Xinjiang were selected. According to the exclusion criteria, 2 cases that did not meet the requirements were excluded, and a total of 140 cases were finally selected. According to whether they had MAFLD, they were divided into MAFLD group (n=60) and non-MAFLD group (n=80). Clinical data between the two groups were compared to explore the influencing factors of MAFLD. Results Compared with the non-MAFLD group, patients in the MAFLD group had a significantly higher male proportion, hemoglobin, total bilirubin (T-BIL), urine albumin, total cholesterol, triglyceride, alanine aminotransferase and aspartate aminotransferase, and lower high density lipoprotein cholesterol (HDL-C)(P<0.05). There were significant differences in daytime nap time, total PSQI, the score of sleep quality factor, the score of sleep disorder factor and the score of hypnotic drug factor between the two groups (P<0.05). Further multivariate logistic regression analysis showed that T-BIL, HDL-C, daytime nap time, sleep quality score and sleep disorder score were the influencing factors of MAFLD (P<0.05). Pearson correlation analysis and scatter plots showed that PSQI score was not correlated with T-BIL, HDL-C and daytime nap time (P>0.05), but significantly correlated with sleep quality factor score and sleep disorder factor score in MAFLD patients (P<0.05). Conclusion In the physical examination population, higher T-BIL, lower HDL-C, longer daytime nap time, worse sleep quality, and more serious the sleep disorder indicate a higher risk of MAFLD.