Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) is a growing global health issue linked to metabolic disorders, affecting all age groups. It can progress to severe liver damage, including cirrhosis and hepatocellular carcinoma, and increases the risk of cardiovascular diseases and cancer. The terminology has evolved from Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction–Associated Fatty Liver Disease (MAFLD) and finally to MASLD, reflecting a better understanding of the disease's pathogenesis. MASLD is characterized by intrahepatic triglyceride accumulation exceeding 5% and involves a complex continuum of disease. It includes Metabolic Dysfunction–Associated Steatohepatitis (MASH), which features liver inflammation, fibrosis, and hepatocellular injury. The disease is influenced by genetic and environmental factors, including obesity, type 2 diabetes, gut dysbiosis, and dietary factors. MASLD is associated with extrahepatic complications such as cardiovascular disease, diabetes, and various cancers. The pathogenesis involves complex interactions between genetic and environmental factors, leading to systemic metabolic dysfunction and liver damage. The disease is managed through lifestyle changes, including diet and physical exercise, and pharmacological approaches targeting metabolic pathways, such as FXR agonists, PPAR agonists, and anti-inflammatory agents. The need for personalized treatment strategies is emphasized due to the complexity of the disease. Current research focuses on developing effective and safe therapies for MASLD, with a focus on improving metabolic homeostasis and reducing liver damage.Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) is a growing global health issue linked to metabolic disorders, affecting all age groups. It can progress to severe liver damage, including cirrhosis and hepatocellular carcinoma, and increases the risk of cardiovascular diseases and cancer. The terminology has evolved from Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction–Associated Fatty Liver Disease (MAFLD) and finally to MASLD, reflecting a better understanding of the disease's pathogenesis. MASLD is characterized by intrahepatic triglyceride accumulation exceeding 5% and involves a complex continuum of disease. It includes Metabolic Dysfunction–Associated Steatohepatitis (MASH), which features liver inflammation, fibrosis, and hepatocellular injury. The disease is influenced by genetic and environmental factors, including obesity, type 2 diabetes, gut dysbiosis, and dietary factors. MASLD is associated with extrahepatic complications such as cardiovascular disease, diabetes, and various cancers. The pathogenesis involves complex interactions between genetic and environmental factors, leading to systemic metabolic dysfunction and liver damage. The disease is managed through lifestyle changes, including diet and physical exercise, and pharmacological approaches targeting metabolic pathways, such as FXR agonists, PPAR agonists, and anti-inflammatory agents. The need for personalized treatment strategies is emphasized due to the complexity of the disease. Current research focuses on developing effective and safe therapies for MASLD, with a focus on improving metabolic homeostasis and reducing liver damage.