OBJECTIVE： To observe the clinical efficacy of metadoxine combined with tiopronin in the treatment of alcoholic liver disease. METHODS： In retrospective study， 70 patients with alcoholic liver disease were selected from Shanxi Provincial People’s Hospital and Taiyuan Third People’s Hospital during Oct. 2013-Dec. 2015， and then divided into treatment group and control group with 35 cases in each group according to therapy plan. Control group was additionally given Tiopronin enteric-coated tablet 0.2 g， po， tid， based on routine treatment； treatment groups was additionally Metadoxine tablet 1.0 g，po，bid， on the basis of control group. Both groups received treatment for 6 weeks. Serum indicators as ALT， AST， γ-GT， TBIL， TC， TG and A/G and serum hepatic fibrosis indicators as Ⅳ-C， HA and Ln were observed in 2 groups before and after treatment as well as the diameters of MPV and SPV， spleen thickness and clinical efficacy. The occurrence of ADR was recorded. RESULTS： The serum levels of ALT， AST， γ-GT， TBIL， TC and TG were decreased significantly in 2 groups， while A/G level was increased significantly； above indicators of treatment group were more significant than those of control group， with statistical significance （P＜0.05）. Serum levels of Ⅳ-C， HA， Ln， MPV， SPV and spleen thickness in treatment group were significantly decreased and lower than in control group， with statistical significance （P＜0.05）. Total response rate of treatment group （94.29％） was significantly higher than that of control group （62.86％）， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Metadoxine combined with tiopronin shows good therapeutic efficacy for alcoholic liver disease with good safety.