Alcoholic liver disease ( ALD) has become a major cause of end- stage liver disease after viral liver cirrhosis. However, the impairments due to excessive alcohol intake have not drawn much attention, especially some clinical syndromes that occur in the advanced stage of ALD, such as Madelung syndrome, pseudo Budd- Chiari syndrome, hepatic osteodystrophy, and alcohol withdrawal syndrome ( AWS) . There is no accurate recognition and timely treatment of these syndromes, thus leading to irreversible damage. The clinical manifestation, possible mechanism, and therapeutic principle of the four syndromes are reviewed, aiming to increase the clinicians' awareness of these signals of excessive drinking and to prevent the development and progression of ALD. Early diagnosis of AWS, as well as timely, effective treatment, can not only reduce misdiagnosis and mistreatment, but also reduce the mortality of patients under intensive care.