High alcohol consumption is one of the most common causes of liver disease. Several markers have been studied for alcohol consumption such as carbohydrate deficient transferrin (CDT), gamma glutamyl transferase, alanine aminotransferase(ALT), aspartate aminotransferase (AST). An elevated serum AST in relation to serum ALT (alanine transaminase) has been proposed as an indicator that alcohol has induced organ damage. Thus when AST:ALT ratio is greater than 2, this is considered as highly suggestive that alcohol is the cause of the patient’s liver injury. The aim of this study was to assess the clinical utility of AST:ALT ratio in alcoholic and nonalcoholic liver disease. This study involved 148 subjects, out of which 74 were diagnosed cases of alcoholic liver disease (ALD) and remaining 74 were age and sex matched diagnosed cases of nonalcoholic liver disease(NALD). Blood samples were collected and plasma AST and ALT activity were determined in both groups(ALD & NALD) by colorimetric method using standard curve . Then the ratio of AST:ALT was calculated and compared in both groups. The plasma activity of AST and ALT was high in both alcoholic and nonalcoholic liver disease patients. Plasma AST, ALT activity and their ratio (AST:ALT ratio) were found to be significantly different in both groups(p < 0.05). AST:ALT ratio less than 2 was found in 95.94% and 29.72% of non-alcoholic liver disease and alcoholic liver disease respectively. The ratio was more than 2 in 4.05% of nonalcoholic liver disease and 70.27% of alcoholic liver disease cases. The ratio of AST:ALT was significantly increased in alcoholic liver disease as compared to nonalcoholic liver disease. Hence, the ratio of AST:ALT can be used as a parameter for the diagnosis of alcoholic liver disease and for the differentiation of alcoholic liver disease from nonalcoholic liver disease