Non-alcoholic fatty liver disease (NAFLD), recently renamed as metabolic dysfunction-associated steatotic liver disease (MASLD), is a major cause of end-stage liver disease and hepatocellular carcinoma (HCC), necessitating liver transplantation (LT). Despite initial concerns, recent data suggest that patients with MASLD do not face higher risks of waitlist drop-out or mortality compared to other etiologies. While peri-transplant complications, particularly infections, may be more frequent in patients transplanted for MASLD, overall graft and patient survival rates are comparable to other etiologies. However, other long-term complications such as diabetes, hypertension, dyslipidemia, and cardiovascular events are more common. Comprehensive pre-transplant assessments focusing on cardiovascular risk, metabolic comorbidities, and renal dysfunction are essential to optimize overall outcomes. In this chapter, we have clarified the change in nomenclature from NAFLD to MASLD and highlighted the challenges in diagnosing MASLD as the etiology of cirrhosis or hepatocellular carcinoma. We also discuss the epidemiology of MASLD with reference to LT, the strategies for pre-LT assessment, medical optimization of metabolic comorbidities, and post-LT immunosuppression.