Purpose of Review <p>The use of non-invasive tests in the prediction of disease progression and decompensation in metabolic dysfunction-associated steatohepatitis (MASH) related cirrhosis is becoming more commonplace. This review summarises existing models and their use in prediction of decompensation, hepatocellular carcinoma (HCC) and cardiovascular events, with guidance on how to incorporate these into clinical decision-making and monitoring strategies.</p> Recent Findings <p>Non-invasive tests used to predict decompensation include the ANTICIPATE-NASH-LRE and ABIDE score, both of which demonstrate good predictive ability. A model incorporating LSM by magnetic resonance elastography into a multivariable model shows promise with excellent predictive ability, however this requires access to specialized MRI equipment and further validation is needed. Novel genetic polymorphisms have not yet been demonstrated to be sufficiently additive to the accuracy of other clinical and biochemical models for the prediction of decompensation. The NFS, BARD and FIB-4 scores are predictive for the development of HCC and cardiovascular events, however these scores are validated in cohorts that include those without cirrhosis and are therefore of limited clinical relevance in cirrhotic patients.</p> Summary <p>Non-invasive tests are being used more frequently to predict outcomes in patients with MASH-related cirrhosis. This enables more individualised management and earlier intervention. Despite recent advancements, there is no single universally applicable and highly accurate predictive model available. Future studies focusing on refining existing models, integrating genetic markers, and validating models in cohorts consisting of patients with MASH and advanced fibrosis would be beneficial.</p>