Recent studies have shown a high incidence rate of metabolic associated fatty liver disease（MAFLD）in people with normal body mass index（BMI），which has not been taken seriously in clinical practice. MAFLD with normal BMI is not the benign dis-ease it was thought to be in the past; it not only has similar metabolic disorders，clinical manifestations，and complications to obese MAFLD patients，but also has its own features in these aspects，and therefore，it should be taken seriously in clinical practice. This arti-cle summarizes the features of MAFLD with normal BMI from the perspectives of pathogenesis，clinical manifestations，prognosis，and treatment，in order to provide a new idea for individualized treatment of MAFLD.