Non-alcoholic fatty liver disease (NAFLD), the most common chronic liver disease that can progress to cirrhosis and liver cancer, is a serious global health concern. NAFLD is strongly linked to metabolic factors and is a major hepatic manifestation of the metabolic syndrome, often accompanied by obesity, diabetes, cardiovascular disease, and other metabolic disorders. To more accurately reflect its pathogenesis, in 2020, the International Liver Panel renamed NAFLD as metabolic-associated fatty liver disease (MAFLD). So far, there is no clear theoretical explanation for its pathophysiological mechanism, which is typically characterized by excessive lipid accumulation in hepatocytes. With hepatocellular damage and fibrosis development, NAFLD will gradually progress to end-stage liver disease. The treatment of early-stage NAFLD mainly advocates dietary and lifestyle changes. Pharmacological treatments for NAFLD mainly target key pathogenic processes and related metabolic disorders, but specific drugs are still insufficient. The prevalence of obesity-related NAFLD and NAFLD-related end-stage liver disease has been steadily rising. These patients do not respond to dietary changes and exercise or cannot achieve weight loss through lifestyle modifications, leading to disease exacerbation. As a result, surgical treatment has become a new option for such patients. Bariatric surgery can improve liver histology, reduce transaminase levels, and the incidence of cardiovascular disease. Common surgical methods include sleeve gastrectomy (SG), adjustable gastric banding (ABG), and Roux-en-Y gastric bypass (RYGB), among which SG is the most commonly used surgical procedure for patients with NAFLD-related cirrhosis. However, bariatric surgery also has some limitations, including the degree of patient tolerance, the technical level of the operator, and the occurrence of perioperative complications, which need to be carefully considered. Its clinical efficacy and safety must be further studied to make it suitable for NAFLD patients. Liver transplantation is the only possible cure for patients with NAFLD-related end-stage liver disease. In recent years, with the mature development of transplantation technology and immunosuppressants, liver transplantation has made considerable achievements in treating end-stage liver disease. However, there are still many problems in the treatment of NAFLD patients. The use of marginal donor liver, the prolongation of the isohepatic phase, the evaluation and management before transplantation, and the recurrence after transplantation all affect the graft and patient survival rates. This article mainly reviews the general situation, general treatment, and surgical treatment progress of NAFLD to provide reference for clinical work.