This study investigated the accuracy of MRI in quantifying liver fat of 86 Chinese children and adolescents, with magnetic resonance spectroscopy (MRS) as reference. MRI and MRS were performed with multi-echo Dixon (ME Dixon) and HISTO sequence respectively to calculate hepatic proton density fat fraction (PDFF). Hepatic steatosis was diagnosed using MRS-PDFF > 5% as threshold. Spearman analysis indicated excellent correlation between ME Dixon and MRS (r>0.9，P<0.01). Bland-Altman analysis demonstrated good agreement between these two methods, indicating that ME Dixon can be an accurate way to detect hepatic steatosis in children and adolescents.