Metabolic Dysfunctions-Associated Steatotic Liver Disease (MASLD) is the new nomenclature recently adopted to overcome the limitations given by diagnostic exclusion criteria used for non-alcoholic fatty liver disease (NAFLD). Type 2 diabetes mellitus (T2DM) plays an essential role in MASLD. Uric acid (UA) is the ultimate enzymatic byproduct from the breakdown of purines in humans. The relationship between UA and liver steatosis remains unclear and there have been limited research carried out in people with T2DM. The aims of our study were to characterize whether serum UA levels associated with MASLD in Caucasian adults with T2DM, and if they could serve as predictors of MASLD in T2DM patients. The study group consisted of 792 participants (491 men and 301 women, aged 18-83) enrolled in the Catanzaro metabolic risk factors study (CATAMERIS). All patients underwent anthropometrical and biochemical characterization. Ultrasonography was used to assess the presence of hepatic steatosis, distinguishing one MASLD group (n=540) and one non-MASLD group (n=252). Liver fibrosis in the MASLD group was determined by FIB-4 score. Serum levels of UA (p=<0.001), BMI (p=<0.001), circulating lipids (p=0.003) and HbA1c (p=0.007) were higher in the MASLD group. UA levels were significantly and positively correlated with sex, BMI, triglycerides, ALT, AST, gamma-GT and negatively correlated with fasting plasma glucose (FPG), HbA1c, HDL and platelets. All these variables alongside age were included as covariates in a logistic regression model revealing a significant association between UA and MASLD in T2DM patients (OR=1.57, 95%CI=1.096-2.268). Additionally, we examined the correlation between UA and liver fibrosis. After adjusting for confounding variables, UA was associated with 30% higher risk of having liver fibrosis in T2DM (OR=1.305, 95%CI=1.081-1.575). In conclusion, our research suggests that serum UA may be used as a marker to study the progression of liver damage in T2DM individuals.