Ooi GJ, et al. – Authors here determined the diagnostic accuracy and reproducibility of a simple intraoperative visual liver score to stratify the risk of non–alcoholic steatohepatitis (NASH) and non–alcoholic fatty liver disease (NAFLD) in obesity and determine the need for liver biopsy. As per findings, the score seemed a useful and reliable tool for NAFLD risk stratification and identification of patients who would most and least benefit from a biopsy. A normal liver appearance reliably excludes significant liver disease, avoiding the need for liver biopsy in patients otherwise at high clinical risk of NASH.