A 29-year-old male who had a 15-year history of alcohol drinking was admitted with a 5-month history of jaundice in July 1989. Laboratory examinations revealed that he had hemolytic anemia and severe liver damage. Erythrocytes of peripheral blood showed typical spiculated cells on light microscopic and scanning electron microscopic studies. Free-cholesterol/phospholipid ratio of the erythrocyte membrane was elevated, and the level of chenodeoxycholic acid increased in serum. The patient was diagnosed as having advanced alcoholic cirrhosis associated with spur cell anemia. Two months after admission, he was complicated with chronic disseminated intravascular coagulopathy (DIC). Anemia, hepatic failure and DIC progressed, and the patient died six months after admission. The mechanism of the formation of spur cells was discussed.