Carnitine is essential for the oxidation of fatty acids. The liver is a major site of fatty oxidation. To determine if there are alterations in plasma carnitine in patients with alcoholic cirrhosis, we measured plasma carnitine and its metabolites by a specific radioenzymatic method in 20 men with hepatic cirrhosis and 30 healthy volunteers. We found total carnitine, free carnitine, short-chain acylcarnitines, and long-chain acylcarnitines to be significantly elevated in the cirrhotic subjects. The mean values for total carnitine, free carnitine, short-chain acylcarnitines, and long-chain acylcarnitines for the cirrhotic patients and the control subjects were 73.1 vs. 46.1, 47.0 vs. 36.7, 17.9 vs. 5.7 and 8.2 vs. 3.7 m̈M, respectively. The greatest increases were noted in the acylcarnitines; 3-fold for short-chain acylcarnitines and over 2-fold for long-chain acylcarnitines. We conclude that alcoholic cirrhosis is a hypercarnitinemic condition.