MASLD, also known as NAFLD, is the leading cause of chronic liver disease in youth, especially among children who are obese and Hispanic/Latino. Insulin resistance and dysglycemia are strongly linked with MASLD. Current methods for evaluating dysglycemia, including fasting glucose, HbA1c, and oral glucose tolerance tests, have limitations. We utilized continuous glucose monitors (CGMs), wearable devices that detect 24 hour, real-time glucose alterations, to test our hypothesis that children with MASLD exhibit greater glycemic dysregulation compared to non-MASLD controls. This study included 19 Hispanic children (63% (12/19) male; mean age 7.8 years ± 0.9; mean BMI percentile 92% ± 17; 5% (10/19)) with MASLD who were otherwise healthy. Hepatic steatosis was measured by magnetic resonance spectroscopy (MRS). MASLD was defined as hepatic steatosis ≥5%, with at least one of five cardiometabolic risk factors. All participants underwent clinical evaluation and wore a blinded Dexcom G6 Pro CGM for 10 days or until the device became detached. Data was analyzed using RStudio v. 4.2.3. In children with MASLD, the mean time in range (TIR, 70-140 mg/dL) of 84% was lower than the mean TIR of 90% observed in non-MASLD controls ( p =0.02). The mean high TIR (140-250 mg/dL) of 16 % in MASLD subjects was significantly higher than the 9% observed in non-MASLD controls (p= 0.01). Mean average glucose and the coefficient of variation (CV) were also higher in children with MASLD, although differences were non-significant ( p >0.05). Fasting insulin and ALT levels were significantly elevated in children with MASLD compared to controls (p< 0.05).Findings demonstrate greater glycemic dysregulation in pre-pubertal children with MASLD compared to non-MASLD controls, as detected by CGM. Importantly, the 24 hour monitoring detected glycemic variability not apparent by fasting glucose or HbA1c. This study suggests early onset MASLD is associated with early glucose dysregulation, and treatments will need to address both conditions.