This review delves into the molecular mechanism that drives alcohol-induced liver cancer and associated comorbidities, emphasizing on the role of specific biomarkers that help in diagnosing these conditions. Chronic alcohol consumption triggers oxidative stress by generating reactive oxygen species (ROS), which disrupt mitochondrial function and cause cell death ultimately. Elevated levels of alanine aminotransferase (ALT) in relation to aspartate aminotransferase (AST) are key indicators of liver injury, shedding light on significant marker for alcoholic liver disease (ALD). Enzymes such as gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) further provide insights into bile duct function and potential risks for hepatocellular carcinoma (HCC) and cholestasis. Hyaluronic acid (HA), procollagen III peptide (Pro-C3), and fibrosis-4 (FIB-4) index also emerge as important biomarkers for liver fibrosis, offering a non-invasive method for assessing the degree of fibrosis through the analysis of ALT, AST, and platelet counts. The review also explores how alcohol accelerates liver damage in individuals with hepatitis B or C infection, by enhancing viral replication and suppressing immune responses. Advanced imaging technologies, such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) reveal the structural changes and tumour presence in the liver, improving the accuracy of diagnosing and monitoring liver diseases with the help of these biomarkers. The other key signatures in alcohol-induced liver disease such as pro-inflammatory cytokines production, insulin resistance, dyslipidaemia, blood pressure, cholesterol levels, and cognitive functions are crucial in assessing liver pathogenesis. These holistic approaches highlight the importance of molecular markers and imaging techniques, allowing for earlier intervention and better patient outcomes.