Excess of alcohol consumption with consequent Alcoholic Liver Disease (ALD) is common cause of liver dysfunction, leading to morbidity and mortality. It encompasses a spectrum of disorders ranging from asymptomatic steatosis, alcoholic steatohepatitis, fibrosis, cirrhosis and its related complication. Multiple mechanisms include oxidative stress, mitochondrial dysfunction, alteration in gut permeability, and activation of TLR-4 has been proposed in pathogenesis. Various risk factors play key role in occurrence and worsening of condition are alcohol consumption, genetic factor, obesity and co-morbidity like hypertension, diabetes, lipid and inflammation. The mainstream of therapy of ALD patients, regardless of disease stage, is prolonged alcohol abstinence. Widely used Silybum marianum extract acts as lifesaving hepatoprotectant. Some medication like pentoxifylline, corticosteroids and N-acetyl cysteine are well established treatment for hepatic failure. Nutritional therapies are also important to meet the deficiencies of nutrients in patients with ALD. Liver transplantation remains emblem of concern for patients with end stage liver disease.