In recent years, the prevalence of non-alcoholic fatty liver disease combined with metabolic dysfunction in children has increased rapidly. Current international guidelines for the management of metabolic-associated fatty liver disease do not recommend any specific drug therapy or its exact effect and safety margin. Appropriate drug therapies for children are even more scarce. Traditional Chinese medicine has good advantages in the prevention and treatment of metabolic-associated fatty liver disease. The author reviewed and analyzed a case with complete clinical data treated in our hospital using traditional Chinese medicine alone and discussed the diagnosis and treatment process. This report aimed to provide a reference for clinical practice.