Abstract: Periodontitis and metabolic dysfunction-associated fatty liver disease (MAFLD) are both highly prevalent chronic diseases that impose a significant global burden. Recent studies have revealed a close association between them. This article systematically reviews the epidemiological link between periodontitis and MAFLD, as well as their potential underlying mechanisms. Regarding the investigation of underlying mechanisms, the article focuses on two primary pathways. Firstly, the classical hematogenous transmission pathway, in which periodontal pathogens and their mediated inflammatory responses affect the liver through the systemic circulation; secondly, the recently proposed “oral-gut-liver axis” pathway, in which periodontitis alters the oral microbiota, subsequently disrupting gut microbiota and intestinal barrier function, ultimately leading to hepatic metabolic dysregulation. These studies offer new perspectives for understanding the complex relationship between these diseases and provide potential novel strategies for the prevention and treatment of MAFLD.