Metabolic associated fatty liver disease (MAFLD) is considered a multisystem disease that can lead to multiple extrahepatic complications, among which cardiovascular disease (CVD) is the most common cause of death in MAFLD patients. MAFLD and its complications share many common metabolic risk factors, which increase the susceptibility to diabetes, hypertension, atherosclerosis, and venous thrombosis through the mechanisms such as inflammation, endothelial dysfunction, oxidative stress, insulin resistance, and abnormal lipid metabolism, and there is a complex interaction between such factors and the pathology of MAFLD, thereby promoting the occurrence of each other. During the progression of MAFLD, there might be changes in various parts of the liver microvasculature, resulting in hepatic microcirculation disturbance, and intrahepatic microvascular disturbance and microcirculation dysfunction are the key to the progression of extrahepatic complications, but MAFLD has not yet been taken seriously like other traditional risk factors. An in-depth understanding of the association between pathological changes of the microvasculature and microcirculation disturbance in MAFLD will help with the mechanism research and treatment of the extrahepatic complications of MAFLD, and more importantly, help MAFLD patients pay more attention to healthcare outside the liver. [ABSTRACT FROM AUTHOR]