Abstract: Purpose of Review: to explain the relevance of Fecal Microbiota Transplantation (FMT) for the treatment of MASLD, the scientifc evidence supporting its usefulness, and the difculties of its translation into efective treatments for use in routine clinical practice. Recent Findings: FMT has been proven efective and safe in other indications and several procedures have been tested for delivery of fecal microbiota to the intestine. The feld awaits results from ongoing clinical trials to better understand the role of FMT in the management of MASLD. Summary: the pathogenesis of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is multifaceted, involving an intricate interaction among genetic predisposition, diet, environmental factors, lifestyle choices, and the gut microbiota (GM). The complexity of these interactions may explain the difculties to obtain an efective pharmacological treatment for MASLD.

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