Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with systemic inflammation and potentially influences the outcomes of critical illness. However, its impact on septic shock remains poorly defined. We aimed to evaluate the association between MASLD score and outcomes in patients with septic shock. We conducted a retrospective cohort study using the National Inpatient Sample (2016-2020) and included adults (aged ≥ 18 years) with septic shock. Patients were stratified