Abstract Several reasons led to the change in the nomenclature from non alcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated steatotic liver disease (MASLD); the most important being limitations due to the reliance on exclusionary confounder terms and the use of potentially stigmatising language (the terms “nonalcoholic” and “fatty”). The new name was decided through a Delphi process and now includes in the name, and definition, the metabolic origin (the presence of at least 1 of 5 cardiometabolic risk factors) without the stigmatising terms. The recognition of a new category termed “metabolic and alcohol related/associated liver disease” (Met-ALD) opens up a new area for exploration although the relative contribution of alcohol and metabolic risk factors requires further evaluation as does the evidencing at a patient rather than population level.