In Europe, alcohol consumption is the leading cause of liver-related mortality. Europe has the highest level of alcohol consumption per person, the highest prevalence of heavy episodic alcohol use, and the lowest rates of abstention from alcohol in the world. These, together with ultra-processed food consumption and high prevalence of obesity, are the major drivers of liver-related morbidity and mortality. Mortality from alcohol-related liver disease is substantially greater for disadvantaged socioeconomic groups, particularly for younger patients, resulting in major health inequalities. This study provides some policy solutions to prevent and reduce the liver disease burden in Europe, and makes recommendations for a paradigm shift in European liver disease response.