Interleukin-8 (IL-8), a cytokine produced by a host of cells including monocytes, macrophages, Kupffer cells and hepatocytes, can activate neutrophils. Peripheral neutrophilia and liver neutrophil infiltration are frequently noted in patients with alcoholic liver disease (ALD). Serum IL-8 levels are markedly elevated in patients with alcoholic hepatitis compared with those in patients with alcoholic cirrhosis, alcoholic fatty liver and non-alcoholic liver disease. The levels are also elevated in patients who die of hepatic failure and correlate with biochemical and histologic parameters and severity of liver injury. Patients with high serum IL-8 had a higher mortality rate than those with lower levels. In liver tissue from patients with ALD, local IL-8 levels also correlated with the degree of neutrophil infiltration. Serum IL-8 levels decreased gradually with abstinence from alcohol. Ethanol can increase plasma endotoxin, a potent inducer of tumor necrosis factor (TNF)-alpha and IL-1. Subsequently, TNF-alpha and IL-1, together with endotoxin, stimulate circulating and local IL-8 in ALD. Activated IL-8 then mediates neutrophil infiltration, a pivotal process in the pathogenesis of ALD. IL-8 levels might reflect the stage and severity of ALD and might serve as a predictor of survival in patients with alcoholic hepatitis. The development of agents with an anti-IL-8 effect is promising for the therapy of ALD.