Alcohol and consequent liver disease are a major burden, which has worsened during the COVID-19 pandemic. There are several facets to the pathophysiology and clinical consequences of alcohol-use disorder (AUD) and progression to alcohol-associated liver disease (ALD), which needs a concerted effort by clinicians, translational and basic science investigators. Several recent advances from bedside to bench and bench to bedside have been made in ALD. We focus this review on a case-based approach that gives a human context to these important questions across the spectrum of ALD.