Alcoholic liver disease (ALD) and its complications are still one of the most frequent causes of death in both developing and developed countries. Abstinence remains the cornerstone of management of all forms of alcoholic liver disease. Treatment modalities for both alcoholic steatohepatitis and alcoholic liver cirrhosis are insufficient. Recent research, which has elucidated the mechanisms of alcohol induced liver injury, offers the prospect of advances in the management of ALD. This review principally focuses on treatment strategies including nutritional support, corticosteroids, anti-inflammatory agents and antioxidant that have been specifically directed at the mechanism involved in the pathogenesis of alcohol related liver injury and considers their current and future role in the management of patients with various stages of ALD. Although these therapies offer a promising response for the future, none have shown consistent benefit. From our study of antioxidant therapy it appears that, antioxidant therapy is more beneficial in alcoholic hepatitis than in alcoholic cirrhosis. Consequently, liver transplantation remains the ultimate option for selected patients alcoholic cirrhosis.