Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD) encompasses a broad spectrum of liver conditions that ranges from simple steatosis to hepatic steatosis, fibrosis, and cirrhosis. It is currently the most common chronic liver disease worldwide and is expected to become the leading cause of liver failure and liver transplantation in Europe in the coming years. Furthermore, MASLD is a multisystemic disease whose main cause of morbidity and mortality is cardiovascular disease. Therefore, it has broad social and economic implications, representing a major challenge for global public health. This update summarizes current relevant aspects on the pathogenesis, natural history, and management of MASLD.