This umbrella review of meta-analyses examined the efficacy of ursodeoxycholic acid (UDCA) in steatotic liver disease associated with metabolic dysfunction (MASLD) based on five meta-analyses including 33 primary studies and 5015 participants. UDCA significantly reduced the levels of liver enzymes: ALT (SMD = -0.36; 95% CI: -0.69 to -0.03), AST (SMD = -0.16; 95% CI: -0.22 to -0.10), GGT (SMD = -0.95; 95% CI: -0.63 to -0.18) and ALP (SMD = -0.23; 95% CI: -0.22 to -0.10). 95% CI: -0.31 to -0.14). Total bilirubin decreased slightly (SMD = -0.08; 95% CI: -0.15 to -0.01), while other markers remained unchanged. Meta-regression confirmed that longer treatment duration significantly improved ALT reduction (-0.04 SMD at 6 months; p = 0.034). UDCA has demonstrated consistent hepatoprotective and cholestasis-modifying effects in MASLD. The overview is registered under CRD420251250211.