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Background/Aims Since the establishment of metabolic dysfunction-associated steatotic liver disease (MASLD), multiple studies have characterized its extent and prognosis in comparison with traditional non-alcoholic fatty liver disease (NAFLD). However, there has been little information on hepatocellular carcinoma (HCC) related to these old and new disease categories. This study aimed to investigate the clinical features and outcomes of NAFLD- versus MASLD-related HCC. Methods This retrospective cohort study involved non-B, non-C patients who underwent hepatic resection for HCC at Asan Medical Center from January 2008 to December 2019. We compared preoperative characteristics and overall survival between patients meeting the NAFLD and MASLD criteria. Results Among the 233 patients with MASLD (n=207) or NAFLD (n=160), 134 fulfilled both steatotic criteria. Patients with MASLD exhibited a significantly higher incidence of underlying cirrhosis (54.1%) compared to those with NAFLD (26.3%; p<0.05). Otherwise, the prevalence of diabetes mellitus (56.5% vs. 43.8%; p<0.05) and hypertension (66.2% vs. 55.0%; p<0.05) was significantly higher in patients with MASLD compared to those with NAFLD. The 5-year overall survival was 82.6% (77.6%–87.9%) for MASLD patients versus 85.0% (79.6%–90.7%) for NAFLD patients, with no significant difference between the groups (log-rank test: p=NS). Among cirrhotic patients, the 5-year overall survival was also comparable at 77.7% (70.3%–85.8%) for MASLD and 81.0% (69.9%–93.7%) for NAFLD (p=NS), and among non-cirrhotic patients, it was 88.4% (82.2%–95.1%) for MASLD and 87.3% (81.5%–93.5%) for NAFLD (p=NS). Conclusion Patients with MASLD-related HCC had significantly higher rates of hypertension, diabetes mellitus, and cirrhosis compared to those with NAFLD-related HCC, though this did not significantly influence overall survival. Our findings suggest that previous data and experiences on NAFLD-related HCC could be utilized in caring and studying MASLD-related HCC patients, particularly in non-cirrhotics. [ABSTRACT FROM AUTHOR]