Background/Aims <p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is now a leading cause of liver complications. This study aims to evaluate the temporal trends in the burden of MASLD-related cirrhosis and liver cancer from 2010 to 2023.</p> Methods <p>Using data from the Global Burden of Disease Study 2023, we analyzed trends in cirrhosis and liver cancer attributed to MASLD across eight selected countries. Incidence, prevalence, and mortality were analyzed and stratified by gender and age.</p> Results <p>In 2023, China reported the highest number of MASLD-related chronic liver diseases (CLD) including cirrhosis cases, with approximately 288.64 million cases, and the highest number of liver cancer cases, at 13,780. The US recorded the highest mortality for MASLD-related CLD including cirrhosis with 6,241 deaths, while China had the highest liver cancer mortality at 9,260 deaths. From 2010–2023, trends showed significant heterogeneity. South Africa experienced the largest increase in cirrhosis prevalence (+ 52.7%), whereas South Korea was the only country with a declining incidence rate (−8.3%). The UK exhibited the most significant increase in MASLD-related liver cancer, with a 100.22% increase in prevalence and a 96.31% rise in new cases. Japan was the only country to show a decline in liver cancer burden. Generally, males bore a higher burden of MASLD-related cirrhosis and liver cancer than females, though notable exceptions existed in specific regions.</p> Conclusions <p>The burden of MASLD-related CLD including cirrhosis and liver cancer represents a significant and growing global public health challenge. Based on current trends, recommendations should prioritize improved risk stratification, early detection of advanced liver disease, and prevention targeting metabolic risk factors.</p> Graphical Abstract <p></p>