Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disease worldwide, affecting approximately 25%-30% of the adult population and closely linked to obesity and type 2 diabetes mellitus.Conventional lifestyle interventions suffer from poor long-term adherence, and pharmacological treatment options remain extremely limited.Against this backdrop, bariatric surgery, as a therapeutic modality capable of achieving significant and durable weight loss along with substantial metabolic improvements, has garnered increasing attention in the management of MASLD.This review systematically summarizes the epidemiological burden and pathological mechanisms of MASLD, examines the clinical and histological evidence for the improvement of hepatic steatosis, inflammation, and fibrosis following bariatric surgery, analyzes its weight-dependent and weight-independent mechanisms of action, and compares the efficacy differences between various surgical procedures.

Key words: metabolic dysfunction-associated steatotic liver disease; bariatric surgery; mechanism study; surgical procedure comparison; pharmacotherapy adjunct