Abstract：Objective：To explore the syndrome and treatment rules of Chinese medicine for metabolic associated fatty liver disease (MAFLD). Methods： Literature on using Chinese medicine to treat MAFLD from January 1，2012 to January 1，2022 were retrieved from CNKI. The literature were screened strictly following the inclusion and exclusion criteria. A total of 225 literature met the standards were obtained，and their syndromes， syndrome elements， treatment methods and medicinal use were evaluated in a multidimensional manner. Results： Five syndromes of MAFLD were commonly seen in clinical practice， including liver depression and spleen deficiency syndrome， binding of phlegm and stasis syndrome， internal accumulation of damp-heat syndrome，internal exuberance of phlegm-damp syndrome and internal accumulation of damp-turbidity syndrome. Qi stagnation， qi deficiency， blood stasis， dampness， phlegm， and heat were the main syndrome elements. The main treatment methods were invigorating blood， removing dampness， strengthening the spleen， soothing the liver， and resolving phlegm. The commonly used Chinese medicinals included Crataegi Fructus， Poria， Alismatis Rhizoma， Atractylodis Macrocephalae Rhizoma， Bupleuri Radix， Salviae Miltiorrhizae Radix et Rhizoma， Citri Reticulatae Pericarpium， Cassiae Semen， Glycyrrhizae Radix et Rhizoma and Pinelliae Rhizoma， with the dosage between 10 and 15 grams. Erchen Decoction，Sini San Decoction，Sijunzi Decoction and Yueju Pills were often involved. Conclusion：Qi stagnation，Qi deficiency，blood stasis and dampness are the key factors of MAFLD. The main syndromes are excess syndrome and deficiency-excess complex. The basic treatment of MAFLD is both attacking and supplementing.