Osteosarcopenic adiposity (OSA) syndrome significantly impacts hepatic disorders more than each of the tissues alone. The purpose of this study is to evaluate the effects of elastic resistance training modality on hepatic health markers, including fatty liver index (FLI), lipid accumulation product (LAP), hepatic steatosis index (HSI), and Framingham steatosis index (FSI)), in the elderly with OSA. Sixty-three eligible patients aged 60-80 years meet the inclusion criteria, including a) body fat percentage (BFP) ≥32%; b) body mass index (BMI) ≥30 kg/m²; c) T-score of L1-L4, and/or total femur or femoral neck -2.5≤T-score ≤-1.0; d) gait speed (10-meter walk test (10MWT) ≤1 (m/s²); and e) skeletal muscle index (SMI) ≤28% or ≤7.76 kg/m². The participants were randomly assigned to experimental (n=32) or control (n=31) groups. The experimental group completed a 12-week elastic-band resistance training program [3x/week; 60 min/session]. The results showed a statistically significant benefit from the elastic-band resistance training on LAP (P=0.033), FLI (P=0.001), HSI (P=0.008), and FSI (P=0.001). Our findings show that an elastic-band resistance exercise training program can improve hepatic function. This relatively low-cost, highly accessible form of exercise can be easily implemented to enhance the health of this population across a wide range of settings.