When Fat Goes Astray: Your Liver and Pancreas Get Into Trouble

ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) and intrapancreatic fat deposition (IPFD) are key manifestations of ectopic fat accumulation that share metabolic pathophysiological links, but differ sharply in clinical research and practice. As a highly prevalent and burdensome chronic liver disease, MASLD has a well‐established research framework. Its diagnostic criteria, risk factors, detection methods, pathophysiology and complications are well‐characterized, with a globally recognized consensus. Artificial intelligence (AI) can facilitate MASLD management, including screening, staging, and prognosis, and approved drugs have been shown to improve outcomes and slow disease progression. In contrast, in the context of IPFD, AI must first address the issue of pancreatic segmentation to meet the requirements for subsequent fat quantification. Owing to its retroperitoneal location, fat‐deposition heterogeneity, and limited understanding of its clinical impact, IPFD lacks universal diagnostic criteria, standardized assessments, and targeted therapies. This review summarizes the latest evidence on MASLD and IPFD, covering fat‐deposition pathology, diagnosis, risk factors, complications, and advances in AI applications and drug therapy; clarifies their similarities and differences; and urges the establishment of standardized diagnostics for IPFD. It also proposes “personalized therapy integrated with the liver‐pancreas axis” to balance disease‐specific traits and inter‐organ interactions, offering new insights for IPFD management.