Metabolic dysfunction-associated steatotic liver disease (MASLD) is a globally prevalent chronic liver disease. As a complex condition caused by multiple factors, the precise pathogenesis of MASLD remains incompletely understood; however, inflammation plays a central role in the pathological development of MASLD.NOD-like receptor family pyrin domain containing 3 (NLRP3) is a critical immune regulatory factor with a pivotal role in the inflammatory response of MASLD. Overactivation of NLRP3 exacerbates chronic liver inflammation and promotes fat accumulation in the liver. Furthermore, excessive activation of NLRP3 leads to the generation of reactive oxygen species, which further activates immune response cells, thereby intensifying liver damage. Inhibiting NLRP3 inflammasome activation has thus become a novel strategy for treating MASLD. Numerous studies have indicated that extracts and formulations of traditional Chinese medicine can effectively alleviate the inflammatory response in MASLD by inhibiting NLRP3 activation, achieving significant progress in its clinical treatment. This review considers the role of the NLRP3 signaling pathway in MASLD and the potential of traditional Chinese medicine for improving MASLD by regulating NLRP3 inflammasome activity, providing a reference for the prevention and treatment of MASLD with traditional Chinese medicine.