Abstract Metabolic dysfunction-associated steatohepatitis (MASH), the progressed period of metabolic-associated fatty liver disease (MAFLD), is a multifaceted liver disease characterized by inflammation and fibrosis that develops from simple steatosis, even contributing to hepatocellular carcinoma and death. MASH involves several immune cell-mediated inflammation and fibrosis, where T cells play a crucial role through the release of pro-inflammatory cytokine and pro-fibrotic factors. This review discusses the complex role of various T cell subsets in the pathogenesis of MASH and highlights the progresses of ongoing clinical trials involving T cell-targeted MASH therapies.