Mitochondria are intimately involved in the generation of and defense against reactive oxygen species (ROS). Mitochondria are themselves targets of oxidative stress and also contribute to mechanisms by which oxidative stress-related signals control cell fate. Ethanol promotes oxidative stress, both by increasing ROS formation and by decreasing cellular defense mechanisms. These effects of ethanol are prominent in the liver, the major site of ethanol metabolism in the body. The question remains to what extent this contributes to ethanol-dependent tissue damage or the susceptibility of cells to other stressors. In this review, we consider how mitochondrial actions of ethanol influence oxidative stress management of liver cells. Mitochondrial electron transport constitutes the major intracellular source of ROS, and ethanol treatment imposes conditions that promote ROS formation by mitochondria, the effects of which may be enhanced by a decrease in mitochondrial oxidative stress defenses. A significant target of ethanol-related increases in oxidative stress is mitochondrial DNA. Ethanol-induced damage to mitochondrial DNA, if not adequately repaired, impairs mitochondrial function, which further increases oxidative stress in the cell, leading to a vicious cycle of accumulating cell damage that is more apparent with advancing age. Uncontrolled mitochondrial formation of ROS promotes the inappropriate activation of the mitochondrial permeability transition, increasing the sensitivity of cells to other proapoptotic or damage signals. In combination with ethanol-induced defects in mitochondrial function, these alterations may promote both apoptotic and necrotic cell death in response to otherwise benign or beneficial challenges and contribute to the onset or progression of alcohol-induced liver diseases.Chronic excessive alcohol consumption causes injury to the liver and other tissues, but, despite intensive study, the factors that relate ethanol intake to the onset and progression of liver disease remain controversial. There is considerable evidence from both human and animal studies that alcohol consumption enhances oxidative stress, in liver as well as in other tissues. However, opinions are divided as to why oxidative stress develops, how it affects liver function, and what its relevance is for liver pathology. 1-6 Mitochondria are recognized as the major intracellular source of reactive oxygen species (ROS), which is generated as a by-product of their major metabolic activity of cellular respiration. 7 Mitochondrial constituents are themselves targets of ROS, and the mitochondrial management of oxidative stress has consequences both for cellular energy metabolism and for the processes that control the onset and progression of the cell death response, whether it results in apoptosis or necrosis. Hence, an understanding of how these complementary functions of mitochondria are affected by alcohol consumption may provide important insights into the mechanisms associated with liver damage. In this review, we wil...