Alcoholic cirrhosis is one of the common causes of hepatic failure. Liver transplantation is the treatment of choice for patients with severe liver failure (Childs B and C). Relation between OLT and psychoactive substance abuse is an issue of increasing interest. An active substance use or dependency disorder has absolute contraindications for the placement of a patient on the waiting list. Adults with alcoholism and substance abuse in remission should not be excluded from transplantation. Many authors believe that 6 full months of abstinence in using psychoactive substances is essential to be placed on the transplantation wait list. While other authors reported that such criteria has no guarantee to predict or exclude a post-transplantation relapse to set the period of abstinence to 6 months seems excessively rigid, and in some cases it does not completely safeguard the health of the patient being assessed. Chronic alcoholism is a direct cause of fatty liver, hepatitis, cirrhosis of liver and hepatocellular carcinoma. It contributes to the development of hepatitis B and C, uncovering of congenital hepatic disorders and predisposes to toxic liver injury. Alcohol does not produce end-stage liver disease in all chronic alcoholics. Previously treatment of alcoholic cirrhosis was limited to the control of complications of portal hypertension, but at present liver transplantation has become an acceptable option of treatment of alcoholic cirrhosis and its complications and transplanted patients have a better overall survival rate.