Low muscle mass (LMM) is a risk factor for adverse health outcomes, but its prognostic relevance in cancer remains insufficiently studied. We investigated the independent and combined effects of LMM and obesity on mortality in cancer patients. This cohort study included 635,867 cancer patients. LMM was defined as the lowest quartile on the appendicular skeletal muscle mass index (ASMI). Obesity was defined as body mass index ≥25 kg/m2 and abdominal obesity as waist circumference ≥90 cm (males) and ≥85 cm (females). Patients were classified into four groups based on muscle mass and obesity status. Cox proportional hazards models calculated adjusted hazard ratios (HRs) and 95