ABSTRACT— We tested lymphocyte cytotoxicity against autologous hepatocytes in patients with alcoholic liver disease (ALD). The following cytotoxicity values were found (mean ± SEM): alcohol-induced steatosis with or without fibrosis 16.5±2% (n = 29), alcoholic cirrhosis 28±4% (n = 13), controls with normal liver histology or minimal changes 6±2% (n = 11). The differences were statistically significant (both forms of ALD versus controls p<0.005). T-cell as well as non-T-cell-enriched lymphocyte fractions showed increased cytotoxicity in ALD. We did not observe a correlation between cellular cytotoxicity and the degree of biochemical or histological alterations within the groups tested. Thus, our study demonstrating enhanced cellular cytotoxicity against autologous hepatocytes in ALD further supports the hypothesis that cellular immune reactions are involved in the pathogenesis of ALD, especially of alcoholic cirrhosis.