Globally, metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease, affecting up to one in three people in the general population, with an estimated increase in prevalence of more than 50% in the last three decades. The rise in prevalence of MASLD will result in substantial increases in the number patients with decompensated cirrhosis and those developing liver cancer by 2030. Despite the complex pathobiology of MASLD, two major breakthroughs in phase 3 clinical trials now herald an era of licensed therapies for MASLD.