Alcohol-associated liver disease (ALD) is a consequence of excessive alcohol use, in terms of diseased liver. It comprises a spectrum of histopathologic changes ranging from simple steatosis, steatohepatitis, and cirrhosis to hepatocellular carcinoma. It is among the leading causes of liver-related mortality and a major indication for liver transplant. The pathogenesis and progression of ALD comprises multiple factors. The natural course of ALD ranges from asymptomatic liver steatosis, alcoholic hepatitis to the development of cirrhosis, and liver cancer. In general it is associated with liver inflammation and injury or progressive fibrosis giving rise to three major classes, each of which rarely exists in a pure form. It is also seen that the severe alcohol-associated liver disease has a very poor prognosis.