Alcoholic liver disease has been shown to progress even after cessation of ethanol intake and the involvement of an immunological mechanism has been suggested. To study whether lymphocyte cytotoxicity for autologous human hepatocytes is involved in the pathogenic process of alcoholic liver disease, hepatocytes (target cells) obtained by a needle liver biopsy from 36 patients with alcoholic liver disease were isolated by enzymatic digestion and incubated with autologous peripheral lymphocytes (effector cells). Using a microcytotoxicity assay, a cytotoxic effect was observed in patients with active cirrhosis or alcoholic hepatitis, but not in those with inactive cirrhosis, hepatic fibrosis or fatty liver. When lymphocytes were separated into T cell enriched and non-T cell enriched fractions, this cytotoxic effect was significantly greater with the non-T cell enriched lymphocyte fraction than with the T cell enriched fraction. The addition of aggregated IgG reduced the cytotoxic effect of the lymphocytes. These results suggested that antibody-dependent cell-mediated cytotoxicity may be of pathogenic importance in alcoholic liver disease.