Gender difference in alcoholic liver disease was evaluated in histologically-proven, hepatitis C virus-negative Japanese patients. The mode of drinking and cumulative alcohol intake were compared according to histological groups. Daily amount of alcohol did not differ between men and women. Mean duration of drinking was shorter and cumulative alcohol intake was smaller in women. However, the mean daily alcohol consumption was greater in women and cumulative alcohol intake did not differ in both gender when alcohol amount was adjusted to body weight. A significant predominance in female patients was shown by analysis on contingency tables in histologically-matched patient group with cumulative alcohol intake less than 500 kg for alcoholic hepatitis, less than 600 kg for hepatic fibrosis and less than 800 kg for liver cirrhosis. In conclusion, women are at risk of developing alcoholic liver disease with fewer cumulative alcohol intake compared with men in hepatitis C virus-negative patients.