Objective To explore the gender differences in the prevalence and influencing factors of nonalcoholic fatty liver disease （NAFLD） in hospitalized schizophrenia patients. Methods A total of 316 schizophrenic inpatients admitted to Shanghai Jiading District Mental Health Center from 1 July 2020 to 30 June 2021 were recruited. Multivariate Logistic regression analysis were applied to analyze schizophrenia inpatients and influencing factors of NAFLD in patients with different genders. Results The prevalence of NAFLD in hospitalized schizophrenics was 41.1% （130/316）， with a prevalence of 42.1% （82/195） in male patients and 39.7% （48/121） in female patients. Multivariate Logistic regression analysis showed that the influencing factors of NAFLD in hospitalized schizophrenia patients were female （OR=2.345， 95%CI=1.159-4.743）， high body mass index （BMI） （OR=1.445， 95%CI=1.296-1.610）， high triglyceride （TG） （OR=2.715， 95%CI=1.709-4.315）， high alanine aminotransferase （ALT） （OR=1.019， 95%CI=1.002-1.037）， long hospitalized time （OR=1.099， 95%CI=1.040-1.162）， diabetes （OR=2.879， 95%CI=1.225-6.768） （P＜ 0.05）. Multivariate Logistic regression analysis showed that high BMI （OR=1.524， 95%CI=1.324-1.753） and high TG （OR=2.841， 95%CI=1.652- 4.887） were the risk factors of NAFLD in male hospitalized schizophrenia patients （P ＜ 0.05）； high BMI （OR=1.370， 95%CI=1.186-1.582） and high blood glucose （OR=1.982，95%CI=1.218-3.225） were the risk factors of NAFLD in female hospitalized schizophrenia patients （P ＜ 0.05）； elder age of onset （OR=0.939， 95%CI=0.889-0.991） was the protective factor of NAFLD in female hospitalized schizophrenia patients （P ＜ 0.05）. Conclusions The prevalence of NAFLD in hospitalized patients with schizophrenia is high， and significantly associated with gender， BMI， TG， ALT， length of hospitalization time and diabetes， and there are gender differences in influencing factors. Therefore， attention should be paid to the prevention and treatment of NAFLD in hospitalized schizophrenia patients in clinical practice.