Abstract: Objective The purpose of this study was to analyze the histo-pathological manifestations of liver biopsy tissues in patients with metabolic-associated fatty liver disease (MAFLD). Methods In this study, a retrospective analysis was performed to collect liver tissue data in 35 patients with MAFLD. All patients underwent liver biopsies in our hospital between August 2017 and December 2022, and the histological manifestations of liver tissues were observed. Results Of the 35 patients with MAFLD, liver histo-pathological examination showed liver steatosis F0 in 8 cases(22.9%), F1 in 16 cases (45.7%), F2 in 5 cases (14.3%) and F3 in 6 cases (17.1%), e.g., liver steatosis in 27 cases (77.1%), of them, the MAFLD activity score (MAS)≥5, suggesting MASH in 11 cases (31.4%); hepatocellular ballooning in 26 cases (74.4%), with and without lobular inflammation in 32 cases (91.4%)and in 3 cases (8.6%), of them, grade 1 in 14 cases (40.0%), grade 2 in 12 cases (34.3%) and grade 3 in 6 cases (17.1%); Mallory-body was found in 5 cases (14.3%); no liver fibrosis in 5 cases (14.3%), significant liver fibrosis in 16 cases (45.7%) and advanced liver fibrosis in 14 cases (40.0%). Conclusion Liver biopsy is important for clarification of histopathological changes, which might help clinicians make an appropriate measures to deal with it.

Key words: Metabolism-related fatty liver disease, Liver biopsy, Histopathology