Elevated liver enzymes are a common finding in primary care medicine, with an estimated prevalence of 8 %. Steatotic liver diseases are the most frequently encountered etiologies and r-epresent the main cause of liver-related morbidity and mortality. This article looks at the latest developments in these diseases, with a particular focus on MASLD (Metabolic dysfunction associated steatotic liver disease). Recommendations include biological monitoring every 1-3 years in the presence of risk factors, and the use of the FIB-4 score to detect fibrosis in cases of MASLD. Therapeutic management aims to improve metabolic function by treating risk factors and through lifestyle and dietary measures.