The damage to liver mitochondria is universally observed in both humans and animal models after excessive alcohol consumption. Acute alcohol treatment has been shown to stimulate calcium (Ca) release from internal stores in hepatocytes. The resultant increase in cytosolic Ca is expected to be accumulated by neighboring mitochondria, which could potentially lead to mitochondrial Ca overload and injury. Our data indicate that total and free mitochondrial matrix Ca levels are, indeed, elevated in hepatocytes isolated from alcohol-fed rats compared with their pair-fed control littermates. In permeabilized hepatocytes, the rates of mitochondrial Ca uptake were substantially increased after chronic alcohol feeding, whereas those of mitochondrial Ca efflux were decreased. The changes in mitochondrial Ca handling could be explained by an up-regulation of the mitochondrial Ca uniporter and loss of a cyclosporin A-sensitive Ca transport pathway. In intact cells, hormone-induced increases in mitochondrial Ca declined at slower rates leading to more prolonged elevations of matrix Ca in the alcohol-fed group compared with controls. Moreover, treatment with submaximal concentrations of Ca-mobilizing hormones markedly increased the levels of mitochondrial reactive oxygen species (ROS) in hepatocytes from alcohol-fed rats, but did not affect ROS levels in controls. The changes in mitochondrial Ca handling are expected to buffer and attenuate cytosolic Ca increases induced by acute alcohol exposure or hormone stimulation. However, these alterations in mitochondrial Ca handling may also lead to Ca overload during cytosolic Ca increases, which may stimulate the production of mitochondrial ROS, and thus contribute to alcohol-induced liver injury.