Metabolic dysfunction-associated steatotic liver disease (MASLD) has been newly defined to better characterize steatotic liver disease (SLD) and is linked to increased risks of cardiovascular disease and chronic kidney disease. However, its impact on kidney transplant (KT) outcomes remains unclear. This study aimed to investigate the association between MASLD and long-term graft outcomes in KT recipients. We identified KT recipients who underwent a national health screening program from 2009 to 2017 using data from the Korean National Health Insurance Service and were followed up until 2021. MASLD was defined based on cardiometabolic criteria and the fatty liver index, incorporating waist circumference, BMI, serum triglycerides, and gamma-glutamyl transferase levels. Recipients with other liver disease etiologies were categorized separately. Cox proportional hazard models were used to assess the association between MASLD and death-censored graft failure and all-cause mortality. Among 8,268 KT recipients, 1,999 (24.2%) had MASLD, while 24 and 417 recipients had alcohol-related/associated liver disease and other liver disease, respectively. The incidence rates of graft failure (MASLD vs. non-SLD, 16.37 vs. 10.64 per 1,0000 person-year, P <.001 for log-rank) and mortality (12.44 vs. 8.77, P <.001) were significantly higher in the MASLD group than those without SLD. In unadjusted analyses, MASLD was associated with a 1.56-fold (95% confidence interval 1.32–1.87) higher risk of graft failure and a 1.43-fold (1.18–1.73) higher risk of mortality. After adjusting for multiple covariates, including demographics, lifestyle, comorbidities, estimated GFR, and proteinuria, adjusted hazard ratios for graft failure and mortality were 1.28 (1.06–1.54) and 1.01 (0.83–1.23). Subgroup analyses showed a consistent association between MASLD and increased graft failure risk, with no significant interactions. Our study suggests MASLD as a significant risk factor for graft failure in KT recipients, emphasizing the need for early identification and intervention. Targeted management strategies for MASLD may improve long-term kidney transplant outcomes.