Hepatic steatosis is widely considered as substantial risk factor for postoperative complications after major hepatectomy and liver transplantation. Nonetheless, studies have been inconsistent regarding the extent of steatosis pertinent to aggravation of liver injury. Furthermore, a significant number of studies failed to show any link between hepatic steatosis and worse postoperative outcome. The confusion is further nourished by the conflicting observations on the impact of steatosis on survival rates following colorectal liver metastasectomy and also on the regenerative capacity of the fatty liver. We assume that these controversies are related to inconsistent evaluation of hepatic steatosis even among expert pathologists. In this mini-review, we will underline the limitations of the histo-pathological assessment of hepatic steatosis. The emerging role of chemical composition of hepatic lipids, particularly the balance between -3 and -6 fatty acids, in liver protection/injury will be highlighted. Finally, the conflicting studies on the impact of various histo-pathological grades and types of hepatic steatosis on the clinical outcome after liver resection and transplantation will be analyzed.