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AimsThis study aimed to explore the association between serum vitamin D and/or dietary magnesium intake levels and severe hepatic steatosis.MethodsThis cross-sectional study collected data from 2,874 individuals in the NHNAES database between 2017 and 2018. Variables were subjected to weighted univariate logistic regression analysis, and variables with ppResultsThe risk of severe hepatic steatosis in overweight and obese individuals was increased in those with deficient serum vitamin D levels (OR: 1.71, 95% CI: 1.13-2.57). No significant correlation between dietary magnesium intake level and severe hepatic steatosis was observed in overweight and obese individuals (all p>0.05). However, an increased risk of severe hepatic steatosis in overweight and obese individuals was found in those with deficient dietary magnesium intake and deficient serum vitamin D compared to those with sufficient serum vitamin D (OR: 1.86, 95% CI: 1.20-2.89).ConclusionDeficient magnesium intake in overweight and obese patients with low serum vitamin D levels may increase the risk of severe hepatic steatosis, however, future studies are required to verify our findings.