The obesity epidemic has led to a dramatic increase in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). While dyslipidemia, type 2 diabetes, and cardiovascular disease guide treatment in patients without evidence of liver fibrosis, liver-related morbidity and mortality become relevant in advanced forms of MAFLD, nonalcoholic steatohepatitis (NASH), and when liver fibrosis develops. Statins should be prescribed for patients without significant fibrosis despite concomitant liver disease but are underused in real-world settings.