Objective: To investigate the relationship between circulatory bile acids and skeletal muscle volume in nonalcoholic fatty liver patients. Methods: A total of 155 patients with non-alcoholic fatty liver disease who were diagnosed in The Second Hospital of Central South University from January 2012 to December 2016 were enrolled in this study. Serum bile acids and metabolic parameters were measured, and serum bile acids and metabolic parameters were analyzed after 12 months of nutritional counseling. Results: Correlation analysis showed that 12α-hydroxysterol bile acid (including deoxycholic acid) levels were negatively correlated with upper and lower extremity skeletal muscle volume and total skeletal muscle volume. Multivariate analysis showed that the level of deoxycholic acid was associated with a decrease in total skeletal muscle volume, whereas the level of non-12α-hydroxysterol bile acids (including chenodeoxycholic acid) was associated with increased skeletal muscle volume in the lower extremities. The changes in chenodeoxycholic acid were positively correlated with the skeletal muscle volume of the lower extremities and negatively correlated with the ΔWHR and Δtotal cholesterol. The change in the total non-12α-hydroxysterol bile acid levels was positively correlated with the skeletal muscle volume of the lower extremities. Conclusion: Circulating bile acids are associated with skeletal muscle volume. 12α-OH bile acids, including deoxycholic acid, are associated with decreased skeletal muscle volume, while non-12α-OH bile acids, including chenodeoxycholic acid are associated with increased skeletal muscle volume. The molecular mechanism underlying the association between bile acid levels and skeletal muscle volume remains to be explored.