Metabolic dysfunction-associated hepatic steatosis (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is characterized by an abnormal accumulation of fat in the liver. Causes include unhealthy lifestyles, hyperlipidemia, hypertension, and type 2 diabetes mellitus, which are associated with obesity and increase susceptibility to the disease. The development of MASLD is related to insulin resistance and impaired fat metabolism, leading to metabolic liver damage. Neutrophils, as key immune cells of the first line of defense against infection and damage, play an important role in the pathogenesis of MASLD. This review examines the pathogenesis of MASLD, the role of neutrophils in the disease, advances in treatment, and their therapeutic potential. Current treatments are difficult to implement and represent a burden on the healthcare system.