A detailed numerical study of the influence of dense gas effects on the large-scale dynamics of decaying homogeneous isotropic turbulence is carried out by using the van der Waals gas model. More specifically, we focus on dense gases of the Bethe–Zel’dovich–Thompson type, which may exhibit non-classical nonlinearities in the transonic and supersonic flow regimes, under suitable thermodynamic conditions. The simulations are based on the inviscid conservation equations, solved by means of a ninth-order numerical scheme. The simulations rely on the numerical viscosity of the scheme to dissipate energy at the finest scales, while leaving the larger scales mostly unaffected. The results are systematically compared with those obtained for a perfect gas. Dense gas effects are found to have a significant influence on the time evolution of the average and root mean square (r.m.s.) of the thermodynamic properties for flows characterized by sufficiently high initial turbulent Mach numbers (above 0.5), whereas the influence on kinematic properties, such as the kinetic energy and the vorticity, are smaller. However, the flow dilatational behaviour is very different, due to the non-classical variation of the speed of sound in flow regions where the dense gas is characterized by a value of the fundamental derivative of the gas dynamics (a measure of the variation of the speed of sound in isentropic compressions) smaller than one or even negative. The most significant differences between the perfect and the dense gas case are found for the repartition of dilatation levels in the flow field. For the perfect gas, strong compressions occupy a much larger volume fraction than expansion regions, leading to probability distributions of the velocity divergence highly skewed toward negative values. For the dense gas, the volume fractions occupied by strong expansion and compression regions are much more balanced; moreover, strong expansion regions are characterized by sheet-like structures, unlike the perfect gas which exhibits tubular structures. In strong compression regions, where compression shocklets may occur, both the dense and the perfect gas exhibit sheet-like structures. This suggests the possibility that expansion eddy shocklets may appear in the dense gas. This hypothesis is also supported by the fact that, in dense gas, vorticity is created with equal probability in strong compression and expansion regions, whereas for a perfect gas, vorticity is more likely to be created in the strong compression ones.