This chapter describes the epidemiology and risk factors involved in alcoholic liver disease. Only 1-2% per year among heavy drinkers develop chronic liver disease. Above a threshold of 20-30 g alcohol daily, the risk of developing cirrhosis increases in a dose-dependent way until the risk function levels out in excessive drinkers. Drinking pattern without food and intermittent drinking habits seems to be associated with increased risk of cirrhosis, while few studies are available to draw firm conclusions regarding beverage specific risk. Women have greater risk for developing alcoholic liver disease compared to men and in addition, several other genetic risk factors are of importance-for example, genetic polymorphisms involved in the inflammatory process and in alcohol metabolism. Several studies suggest a negative effect of concomitant hepatitis C infection, that is, a risk of developing alcoholic liver disease. Smoking increases the risk of liver disease in heavy drinkers, while coffee seems to have a protective effect. An increased risk of liver disease is seen in patients with genetic hemochromatosis and concomitant alcohol intake, while there is not sufficient evidence for the effect of iron in heavy drinking patients without hemochromatosis.