The objective of this chapter is to introduce the alcoholic liver disease. Alcoholic liver disease is a leading cause of liver cirrhosis in the western population. Alcoholic liver disease (ALD) includes three distinctive liver diseases following as hepatic steatosis, alcoholic steatohepatitis (ASH) and cirrhosis. This chapter covers the pathophysiology of ALD, clinical features of ALD, laboratory investigation, microscopy, and features suggestive of alcoholic steotohepatitis over NASH. Alcoholic steotohepatitis (ASH) on a liver biopsy show mixed features including cholestasis, steatosis, and predominance of MDB’s.