Nonalcoholic fatty liver disease (NAFLD) has taken its place as one of the top GI and liver disorders on the minds of clinicians, researchers and the pharmaceutical industry. The global focus on metabolic liver disease is appropriate, given that NAFLD affects roughly 25% of the world’s population and has become a main focus in liver transplant programs. Efforts to understand the nature of the disease and to improve diagnostics and therapeutics are progressing at an extremely rapid pace; thus, it is important to periodically summarize and reflect on these developments.