According to data on China’s disease burden in 2019 published by the Lancet, alcohol consumption is the 10th leading risk factor for death. However, the pathogenesis of alcoholic liver injury caused by drinking is very complicated, and there is still no final conclusion. The toll-like receptor 4 signaling pathway has a key role in the occurrence and development of alcoholic liver injury. Therefore, this article reviews the role of the toll-like receptor 4 signal transduction pathway in alcoholic liver injury.