Alcoholic liver disease (ALD) refers to liver damage caused by long-term heavy drinking, and can lead to hepatocellular necrosis and even liver failure in severe cases. The search for active substances with ameliorating effects on ALD has recently become a hot topic focus for researchers in various fields. Polysaccharides represent a major class of natural product, and are widely found in plants, animals, and fungi; they are safe and non-toxic, and can have protective effects on the liver, offering hope for an effective ALD treatment. Therefore, polysaccharides display high potential for development of new drugs for ALD. Research into the ameliorating effects of polysaccharides in ALD has rapidly proliferated, and a large number of research results have been published. This review summarizes the pathogenesis of ALD, the types of polysaccharides that can be used to treat ALD, and the mechanism underlying polysaccharide action in ALD, It also discusses future prospects for polysaccharide mediated intervention in ALD, in the hope of providing a frame of reference for future research.