Purpose of Review <p>Alcohol associated hepatitis is a growing concern worldwide. Early liver transplantation is considered the recommended therapy of choice for patients with severe AAH. However, in resource-limited settings, early LT for severe AAH is challenging due to lack of universal health coverage and paucity of donor programs.</p> Recent Findings <p>Medical management has improved significantly in recent years, resulting in a greater survival benefit for patients with severe AAH. The fear of infections associated with the use of corticosteroids is waning, and several other therapeutics have shown promising efficacy in treating severe AAH.</p> Summary <p>In this review, we discuss the medical management of patients with severe AAH and provide an outline of approaching a patient with severe AAH. </p>