Clinical manifestation of alcoholic hepatitis is a serious and adverse sign of progression of alcoholic liver disease. Therapy of acute alcoholic hepatitis is currently limited to symptomatic therapy and prednisolone. The aim of our study was to analyze pentoxifylline and prednisolone combination in patients with severe acute alcoholic hepatitis. 136 patients with severe acute alcoholic hepatitis (Maddrey discriminant function > 32) were included. Patients in the control group (73 patients) received symptomatic therapy, the patients in the first study group (41 patients) additionally received 400-600 mg pentoxifylline intravenously. The second study group (22 patients) additionally treated by combination of pentoxifylline and prednisolone. In the group of patients treated with pentoxifylline significant reduction in creatinine was determined (p <0.05). Short-term mortality in pentoxifylline group of was lower (15 %) than in the control group (25%). In prednisolone and pentoxifylline combination groups was the maximum mortality rate - 45%. Pentoxifylline improves short-term survival in patients with severe acute alcoholic hepatitis, significantly reduces the incidence and mortality from hepatorenal syndrome. The combined use of prednisolone and pentoxifylline probably negates the positive effect of pentoxifylline against hepatorenal syndrome.