Fatty liver disease, including metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), affects approximately 30% of Americans and can progress to serious liver conditions such as cirrhosis and liver cancer. Semaglutide, marketed as Wegovy among others, is a glucagon-like peptide-1 (GLP-1) receptor agonist that has recently gained FDA approval for treating adults with noncirrhotic MASH and moderate to advanced liver fibrosis. This approval marks a significant advancement in fatty liver disease management, as effective pharmacological treatments have been limited. Semaglutide works by improving insulin sensitivity, reducing liver fat accumulation, and potentially reversing fibrosis, which aligns with its benefits observed in glycemic control and weight reduction in diabetes and obesity treatments. Furthermore, by targeting the underlying metabolic dysfunction, semaglutide may reduce inflammation and halt disease progression from simple steatosis to more severe stages like cirrhosis. Patients with fatty liver face risks of fibrotic liver changes, cirrhosis, and ultimately liver cancer if untreated. Introducing semaglutide expands the therapeutic options available, complementing lifestyle modifications such as diet and exercise. Its use should be part of a comprehensive clinical strategy to monitor liver function, disease progression, and overall metabolic health. Ongoing research is evaluating long-term efficacy and safety, as well as the drug’s mechanism in liver tissue remodeling. Healthcare providers should consider patient-specific factors and possible side effects when prescribing semaglutide. This evolving treatment landscape offers hope for millions affected by fatty liver disease, emphasizing the importance of early diagnosis and intervention to prevent irreversible liver damage.