Abstract： Metabolic dysfunction-associated steatotic liver disease （MASLD） is a common chronic liver disease. Based on the dampness， turbidity， and stasis theory， the authors believe that spleen deficiency with dampness exuberance is the onset of MASLD， dampness stagnating and generating turbidity is the pivotal point of progression， and the intermingling of turbidity and stasis forms the foundation of chronic disease. With the therapeutic principle of harmonizing yin and yang， and the treatment methods of draining dampness， descending turbidity， and resolving stasis and dispersing masses，the Shenshi Jiangzhuo Prescription was developed. This prescription promotes the smooth flow of the four pathways—the airway， waterway， grain way， and blood way—to achieve the effects of draining dampness， descending turbidity， and resolving stasis and dispersing masses. This article elucidates the interrelationships and pathogenic characteristics of dampness，turbidity，and stasis，summarizes the evolution of the traditional Chinese medicine pathogenesis of MASLD， and explores the traditional Chinese and western medicine mechanisms of Shenshi Jiangzhuo Prescription in treating MASLD in conjunction with modern research， aiming to provide a theoretical basis for the clinical promotion and application of this formula.