2023 brought with it a BIG guideline update from the American Association for the Study of Liver Diseases (Rinella, et al. 2023) on the condition previously known as non-alcoholic Fatty Liver Disease (NAFLD). NAFLD, which is estimated to impact up to 25% of the US population, has been an area of intensive research since the prior published guidelines in 2018. This newest publication provides substantive updates to the best practices for evaluation and management of the newly re-named Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) (Rinella, Lazarus, et al. 2023). This lecture will review the guidelines and implications for clinical practice, with special focus on the newest recommendations regarding the use of biomarkers and other non-invasive tests for diagnosis and management of NAFLD/MASLD, as well as when referral to higher levels of care would be appropriate.