Patients who undergo pancreaticoduodenectomy (PD) are at risk of steatosis because resection of the pancreatic head causes pancreatic exocrine and endocrine insufficiency. We investigated the clinicopathological features and the risk factors of nonalcoholic fatty liver disease (NAFLD) after PD. This was a retrospective study of 100 patients who underwent PD between April 2007 and December 2012 in our institution. Preoperative demographic and clinical data, surgical procedures, pathological diagnosis, postoperative course findings, and complication details were collected prospectively. The patients were divided into the following two groups: Group A consisted of 12 patients who developed postoperative NAFLD, and Group B consisted of 88 patients who did not develop postoperative NAFLD. Pancreatic carcinoma and pancreatic texture showed similar findings. Additionally, we found that blood loss significantly correlated with the incidence of nonalcoholic steatohepatitis after PD. In multivariate analysis, only blood loss was identified as the most influential risk factor for NAFLD (hazard ratio, 1.0001; P = 0.016). Blood loss was identified as an independent risk factor for the development of NAFLD after PD. Further prospective studies are needed to identify factors that put patients at risk for NAFLD after PD. Continuing efforts should be made to improve patient outcomes and understand the pathogenesis of postpancreatectomy NASH.