Based on the significant advantage of MAFLD to NAFLD with regard to metabolic assessment, therefore, the purpose of this study was to examine the association between serum PRL levels and the occurrence of MAFLD and liver fibrosis in a population with T2DM stratified by different PRL subgroups and genders, aiming to provide novel insights into the correlation between serum PRL and the severity of MAFLD within a similar population. Here, PRL is linked to metabolic dysfunction-associated steatotic liver disease.