Relationship between ethanol drinking and organs injury was reviewed and special emphasis was put on alcoholic liver disease. Consumption of alcoholic beverage expressed as ethanol per capita of adult in Japan increased 2.1 times in these 25 years and it is still increasing. Although the incidence of alcoholic liver disease in Japan also increased greatly during the above period, it seems likely that plateau level is coming because of genetically defined, unique type of alcohol metabolism in Japanese. Sex differences in susceptibility to alcohol were discussed. Among the six types of alcoholic liver disease, alcoholic liver fibrosis is relatively frequent in Japan. Mechanism of liver injury has been studied extensively. Alcohol itself is toxic but other factors such as dietary fat are also important. Biochemical and immunological markers of drinking were presented. As for the treatment, most patients especially in early stages of the disease well respond to alcohol withdrawal, but therapy of alcohol dependence in the background of the disease is very difficult requiring cooperative works of different kinds of specialists.