Measurements of ionized blood calcium were carried out in 38 subjects: 14 controls and 24 patients with chronic alcoholic liver disease (non-cirrhotic in 7, cirrhotic compensated in 2 and cirrhotic decompensated in 15). Compared with the control group, a significant decrease in ionized calcium was found in patients with decompensated cirrhosis. Through secondary hyperparathyroidism, this hypocalcaemia might contribute to the demineralization of the bones observed in cirrhotic patients.