Alcoholic liver disease (ALD) is a liver disease caused by chronic heavy drinking, including alcoholic fatty liver, alcoholic hepatitis, alcoholic cirrhosis, and alcohol-related hepatocellular carcinoma. Its pathogenesis is closely related to the direct toxic effects of alcohol and its metabolite acetaldehyde on the liver, oxidative stress, and nutritional imbalance. Pathologically, it manifests as hepatocellular steatosis, necrosis, and regeneration, which eventually leads to liver fibrosis and cirrhosis. Imaging (ultrasound, CT, and MRI) is an important tool in the diagnosis of ALD. CT shows hypodensity of the liver parenchyma and relatively high density of vascular shadows; MRI shows homogeneous hyposignalization of the liver parenchyma without significant enhancement on enhancement scans. MRI shows uniform hyposignalization of the liver parenchyma with no significant enhancement on enhancement scan. The diagnosis should be based on the history of alcohol consumption and imaging findings and should be differentiated from intrahepatic space-occupying lesions.