To evaluate the relationship between fat-storing cells and fibrosis of the liver in alcoholic liver disease, the characteristics of fat-storing cells were studied by light microscopy with a modification of Kupffer's gold chloride method. Liver biopsy specimens were obtained at laparoscopy with a Trucut needle from 59 patients with alcoholic liver disease, 10 with no hepatic fibrosis, 18 with mild fibrosis, 18 with moderate fibrosis, and 13 with liver cirrhosis. These specimens were divided into three classes (weak, moderate, and strong) with respect to the response of fat-storing cells to the gold chloride reaction, which indicates the amount of vitamin A contained in fat-storing cells. It was found that in alcoholic liver disease the gold chloride reaction became weaker as hepatic fibrosis progressed (P less than 0.001). By contrast, no significant association was observed between the gold chloride reaction and the degree of hepatic fibrosis in 74 specimens from patients with nonalcoholic liver disease. These results show that in alcoholic liver disease hepatic fibrosis is characterized histochemically by the reduced response of fat-storing cells to the gold chloride reaction. The role of the change in fat-storing cells in alcoholic liver disease remains to be elucidated.