Even though alpha-fetoprotein has long been implicated with inflammation during pregnancy and adult liver dysfunction, the literature lacks a review of such a relationship. Clarification of the role of alpha-fetoprotein in the inflammatory response is explored in the present report regarding AFP's participation as a positive and/or negative phase inflammatory reactant. Inflammation follows a complex succession of vascular changes involving alternations in blood and lymphatic vessels both at local intracellular sites and at the organ (liver) level. The inflammatory response may result in either an acute phase or develop into a chronic phase following injury or insult from foreign bodies, microbes, toxins, carcinogens, or autoimmune self-antigens. The site of inflammation attracts pleiomorphic cell infiltrates which secrete various chemical mediators such as cytokines, chemokines, interferons, histamines, and a host of others. It is herein demonstrated that alpha-fetoprotein can serve both as an acute and a chronic phase reactant depending on its stage of ontogeny. It was found that alpha-fetoprotein functions as a positive acute phase reactant in the embryo, fetus, and placenta during pregnancy. In contrast, alpha-fetoprotein proceeds to function as a negative acute phase protein in the postnatal and adult periods of life, especially following liver dysfunction and toxic insult. In chronic viral-induced inflammation of the liver, especially viral hepatitis, alpha-fetoprotein appears to serve as a positive phase inflammatory reactant.