The diagnostic criteria for MASLD has evolved to incorporate the definition of hepatic steatosis with inclusion of cardiometabolic risk factors. Current management guidelines recommend lifestyle interventions, such as dietary changes and increased physical activity, supported by a multidisciplinary team (MDT). However, real-world data on the effectiveness of MDT-led care for MASLD remains limited, despite the growing prevalence of MASLD alongside rising obesity rates. This study aimed to evaluate the impact of multidisciplinary input, including dietetics and an exercise physiologist support, on MASLD and its associated biochemical markers. A retrospective cohort study was conducted on patients presented for weight excess management under endocrinology, with access to multidisciplinary care. Inclusion criteria required evidence of hepatic steatosis and at least one cardiometabolic risk factor (elevated BMI, HbA1c, hypertension, or dyslipidaemia). Outcomes were assessed before and after a minimum of six months of MDT involvement, focusing on changes in liver ultrasound, weight, HbA1c, and fasting lipid profile. In a total of 50 patients, 21 received MDT input: all saw a dietitian, 17 consulted an EP, and 5 met with a bariatric surgeon. Fifteen patients attended more than one follow-up session for both diet and exercise. Participants with MDT input experienced greater weight reductions (115.54kg to 100.07kg, change of 15.48kg; p=0.01) and BMI (41.26kg/m² to 36.00kg/m², change of 5.27kg/m²; p= 0.02). While HbA1c improvement was smaller in the MDT group (6.21% to 5.81%, change of 0.39%; p=0.22), reductions in hepatic steatosis grading were greater (2 to 1.56, change of 0.44; p=0.61). Our findings support the value of structured MDT care in achieving meaningful clinical improvements in MASLD. Longitudinal patient engagement appears key, highlighting the importance of integrating MASLD management into broader obesity and metabolic health strategies.