Understanding the precise anatomy and treatment for median arcuate ligament syndrome (MALS) is crucial as minimally invasive surgery becomes more prevalent.

• Experts reached consensus on 13 statements regarding MALS, achieving over 75% agreement.
• Evidence-based recommendations highlight key diagnostic and surgical approaches for optimal outcomes.

These insights should enhance surgical decision-making and improve patient care in MALS.

• The consensus serves as a guideline for safe and effective MALS treatment worldwide.