Alcoholic liver disease is a major health problem in the United States and worldwide without successful treatments. Chronic alcohol consumption can lead to alcoholic liver disease (ALD), which is characterized by steatosis, inflammation, fibrosis, cirrhosis and even liver cancer. Recent studies suggest that alcohol induces both cell death and adaptive cell survival pathways in the liver, and the balance of cell death and cell survival ultimately decides the pathogenesis of ALD. This review summarizes the recent progress on the role and mechanisms of apoptosis, necroptosis and autophagy in the pathogenesis of ALD. Understanding the complex regulation of apoptosis, necrosis and autophagy may help to develop novel therapeutic strategies by targeting all three pathways simultaneously.