Abstract: Liver diseases are one of major causes of disease burden in China.The composition of chronic liver diseases has changed significantly in China over the past years.The incidence of alcoholic liver disease has increased gradually.Acetaldehyde dehydrogenase 2 (ALDH2) is the principle enzyme responsible for hepatic metabolism of ethanol.Approximately 8% of individuals have the inactive ALDH2 genotype around the world,especially in the East Asian population.Presence of the mutant or inactive ALDH2*2 gene may lead to accumulation of acetaldehyde as the ethanol metabolite.Acetaldehyde is a toxic material which can cause multiple organs to be injured in the individuals with acetaldehyde accumulation.The relationship between the mutant ALDH2*2 gene and a variety of liver disorders including alcoholic liver disease needs to be explored.In the present article,we review the recent advances in understanding the relationship between ALDH2 gene polymorphisms and liver diseases,in order to provide a better understanding of the difference in the characteristics of liver disease between the Eastern and Western populations,which can help develop new strategies to prevent and treat liver diseases.