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A growing body of evidence supports the use of glucagon-like peptide-1 (GLP-1) agonists in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Phase III data demonstrate that once weekly subcutaneous semaglutide (trade names including Ozempic and Wegovy) at a dose of 2.4 mg reduces both steatohepatitis and liver fibrosis in patients with MASLD .1 Tirzepatide (Mounjaro or Zepbound) is a GLP-1/gastric-inhibitory peptide coagonist. Phase II data show tirzepatide is effective in resolving steatohepatitis in patients with MASLD with fibrosis at 52 weeks.2 However, no real-world data exist investigating the use of tirzepatide in patients with type 2 diabetes mellitus (T2DM) and MASLD to understand the impact on both their diabetic control and underlying liver disease.3