Abstract:Metabolic dysfunction-associated steatotic liver disease (MASLD) has become one of the most prevalent chronic liver diseases worldwide, and conventional metabolic risk factors alone cannot fully account for its rapidly increasing disease burden. In recent years, endocrine-disrupting chemicals (EDCs) have emerged as important environmental risk factors for MASLD. Increasing epidemiological evidence suggests that exposure to bisphenols, phthalates, per- and polyfluoroalkyl substances, persistent organic pollutants, and heavy metals is associated with hepatic steatosis, liver enzyme abnormalities, and liver fibrosis. Experimental studies indicate that EDCs contribute to MASLD by disrupting nuclear receptor-mediated transcriptional regulation, inducing mitochondrial dysfunction and oxidative stress, impairing gut microbiota homeostasis and the gut-liver axis, and potentially exerting long-term or transgenerational effects through epigenetic mechanisms. Preventive strategies aimed at reducing environmental exposure, optimizing lifestyle interventions, and targeting metabolic pathways may offer therapeutic potential; however, specific biomarkers and high-quality clinical evidence for EDC-related MASLD remain limited. This review summarizes the epidemiological evidence, molecular mechanisms, and prevention strategies linking EDCs to MASLD, and discusses future research priorities to facilitate risk assessment, precision prevention, and clinical translation.