Abstract: Metabolic associated fatty liver disease (MAFLD) is one of the most common chronic liver diseases worldwide, and it can gradually progress from simple hepatic steatosis to metabolic associated steatohepatitis (MASH), liver cirrhosis and even liver cancer. Genetic susceptibility, insulin resistance, lipotoxicity, chronic inflammation and gut dysbiosis were multiple causes leading to MAFLD. In recent years, research on the regulation of host metabolism and liver homeostasis by the gut microbiota through the gut-liver axis had achieved signif icant advances. Indole and its derivatives, as tryptophan metabolites produced by gut microbiota, had received extensive attention. Studies showed that the levels of indole and its derivatives in patients with MAFLD were signif icantly reduced, and supplementation with these metabolites could alleviate liver injury through multiple mechanisms. In this paper, recent research progress on intestinal fl ora-driven indole and its derivatives in the development of MAFLD, including the regulation of indole and its derivatives by intestinal fl ora, the molecular mechanisms underlying the protective ef fects of indole and its derivatives on the liver, and the progress of treatment strategies based on the gut fl ora-indole metabolite axis were reviewed, in order to provide new insights into potential therapeutic targets for MAFLD.