Objective：The co-existence of fatty liver and chronic hepatitis B（CHB） is common among patients. The study was aimed to explore the prognosis of CHB patients complicated with fatty liver. Methods：A retrospective study of 915 patients with CHB treated in the department of infectious disease of Jiangsu Province Hospital between 2016 and 2017 was conducted. Liver steatosis assessment was performed using Fibroscan. HBV DNA viral load and the degree of liver fibrosis were compared between the two groups with or without fatty liver. Results：Among the 915 CHB patients，447 of whom were diagnosed with fatty liver（48.8%）. Controlled attenuation parameter（CAP） value was negatively correlated with HBV DNA level. Compared with the simple CHB patients，CHB with fatty liver had a lower degree of liver fibrosis（OR=0.79，95%CI：0.67-0.92，P=0.003）. CAP values were U-shaped correlated with alanine transaminase. Conclusion：This finding indicates that the severity of liver inflammation is aggravated in CHB patients with severe fatty liver.