Abstract: The shortage of donor livers has become the main obstacle restricting the clinical development of liver transplantation. The rational use of marginal donor livers is an effective way to alleviate the shortage of donor livers. With the development of society and the changes in people's diet and lifestyle, the incidence of obesity and steatotic liver disease are continuously increasing. Steatotic livers provide an opportunity to alleviate the shortage of donor livers by expanding the donor pool. Many studies have shown that compared with normal donor livers, steatotic donor livers are more sensitive to ischemia-reperfusion injury. This review will summarize the current mechanisms and repair strategies of ischemia-reperfusion injury in steatotic livers, providing references for the rational use of steatotic donor livers and ideas for expanding the donor pool for liver transplantation.