The aim of this study was to investigate the relationship between alcohol metabolizing enzyme genotypes and mortality risk of liver diseases among patients with alcohol dependence. A total of 130 male patients with a DSM-III-R diagnosis of alcohol dependence (mean age 40+/-10 years) were recruited consecutively to the study from 1994 to 1995. Blood biochemistry and hepatitis B viral surface antigen (HBsAg) were measured. The genotypes of ADH2, ADH3 and ALDH2 were determined by polymerase chain reaction and restriction fragment-length polymorphism. The mortality cases were identified by matching data files of the death certification system of the National Department of Health issued from 1994 to 2001. Mortality analysis revealed that 58 of 130 cases (45%) died during the follow-up period. Among them, 21 cases died of liver diseases. Mortality was not higher in HBsAg positive than in negative subjects. The genotypes of alcohol metabolizing enzymes are not associated with the mortality risk of liver diseases. The small sample size was a limitation of this study. How functional genetic polymorphism of the alcohol metabolizing enzymes causes liver damage is still not clear. Continuous study of this topic is necessary.