The term non-alcoholic fatty liver disease (NAFLD) was used in 1986 by Schaffner, who observed that the inflammatory state typical of non-alcoholic steatohepatitis (NASH) was not present in NAFLD [
1]. NAFLD is identified as a syndrome characterized by the fat accumulation in the liver parenchyma and encompasses a broad spectrum of pathologies including simple fatty liver, non-alcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma through progressive fibrosis [
2,
3]. Currently, it has been proposed that the definition of fatty liver disease associated with metabolic dysfunction (MASLD) may represent a more comprehensive terminology than the acronym NAFLD since it overarches the relationship between hepatic fat deposition and metabolic dysfunction. Up to now, no specific drugs have been identified for the treatment of MASLD patients. The management of MASLD patients involves changes in lifestyle and the consumption of a healthy diet [
4,
5]. The Mediterranean diet is recognized for both the decrease in the cardiovascular diseases risk and for the reduction of the metabolic syndrome risk and thus it has been efficient therapeutical approach in MASLD patients [
6,
7]. In this regard, the scientific community has made considerable efforts in identifying nutraceutical compounds useful in MASLD patients. Onion (
Allium cepa) is believed to have originated in central Asia but it is farmed globally and eaten regardless of the cuisine and ethnic group. Cooked, fired or raw, the onion is irreplaceable ingredient of the Mediterranean diet. This perennial or biennial bulbous monocotyledon which belongs to the Liliaceae family is rich in various nutraceutical compounds, such as flavonoids, anthocyanins, organosulphur compounds, saponins and phenols. Numerous beneficial properties are attributed to the nutraceutical compounds in onions, including antioxidant, antitumour, anti-diabetic and anti-inflammatory activities [
8]. Thus, the nutraceutical compounds from A. cepa may be observed as potential ligands for carefully selected target proteins that interfere with MASLD development and progression. Promising targets for the identification of new pharmacological strategies useful in MASLD include 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), peroxisome proliferator-activated receptors (PPARs) and Liver X receptors (LXRs). HMGCR is an enzyme involved in the biosynthesis of cholesterol. HMGCR catalyses the reduction reaction of (S)-HMG-CoA to (R)-mevalonate, using two molecules of NADPH [
9]. Statins, hypolipidemic drugs are the main inhibitors of HMGCR. Currently, the usefulness of statins in MASLD patients has been demonstrated due to their ability to reduce liver enzyme concentrations and improve the liver histology of patients. Furthermore, it has been observed that statins reduce the risk of developing MASLD [
10]. On contrary, the administration of statins is related to side effects such as the increase in liver enzymes as markers of inflammation. Peroxisome proliferator-activated receptors (PPARs) comprise three subtypes: PPARα, PPARδ and PPARɣ. The PPARα is involved in the processes of fatty acid absorption and oxidation and lipoprotein metabolism and it is mainly expressed in the liver, the kidney, the heart and the muscles. PPARδ is observed in most cells, while PPARγ is expressed in macrophages, large intestine and adipose tissue, where it is involved in adipocyte differentiation processes and lipid metabolism. Fibrates by activating PPARα, promote the formation of high-density lipoprotein (HDL) and reduce the concentration of triglycerides (TG) in the blood and thus present the drugs of choice in dyslipidaemia [
11]. Given the therapeutic effects of fibrates, the representatives of the new generation, saroglitizar and lanifibranor, are in clinical trials for MASLD and seem to meliorate NAFLD and NASH [
12]. Thiazolidinediones (TZDs), PPARγ agonists, are mainly used in the treatment of type II diabetes due to their insulin-sensitising action and ability to reduce plasma glucose levels. TZDs, and in particular pioglitazone, improve liver histology in NAFLD patients, although their application is limited due to the side effects. LXRs (α and β isoforms) are nuclear receptors involved in many metabolic processes, such as cholesterol homeostasis, liponeogenesis and the inflammatory response. The LXRα isoform is expressed in tissues with high metabolic activity (liver, small intestine, kidney), whereas LXRβ can be found ubiquitously [
13]. Recent studies suggested that LXRs play a role as gatekeepers in NAFLD/NASH progression. Activation of LXRβ in stellate cells exerts anti-inflammatory and antifibrotic activities, preventing progression to fibrosis; while activation of LXRs in hepatocytes suppressed the transactivation of genes that promote NASH. LXRs are promising molecular targets for MASLD by virtue of the numerous cellular processes in which they are involved, but the complexity of their involvement in the disease requires further study. In this study, selected molecular targets were molecularly docked using a library of naturally occurring onion compounds in order to identify promising small molecules that could provide beneficial effects in MASLD patients.