The present study in a large cohort of individuals with NAFLD/NASH clearly shows that the key markers of senescence, SA-β-Gal, p16, p21 and p53, are increased in liver cells in NAFLD, further increased in NASH, and related to both amount of liver fat, as well as a pathologist’s grading of NAFLD and NASH. Here, TP53 is linked to metabolic dysfunction-associated steatotic liver disease.