Objectives. Severe acute alcoholic hepatitis represents an important cause of death in patients with high alcohol consumption all over the world. Identifying the factors that lead to a bad prognosis and high mortality would help us to choose the best strategy in managing and treatment of these patients. Aims: The aim of this study is to evaluate the clinical and biological features of patients with severe acute alcoholic hepatitis. Materials and methods. This study included 62 patients presenting with alcoholic liver disease consecutively admitted to the Hepatology unit of Republican Hospital, in Chisinau, Republic of Moldova during the period from November 2017 till May 2018. The diagnosis of alcoholic liver disease was made when a history of alcohol abuse (>3 standard drinks for male and > 2 drinks for female) was present until 1 month of onset of symptoms. Demographic, clinical and laboratory parameters were collected. Maddrey’s discriminant function index (DF) and Model for end-stage liver disease (MELD) were calculated on admission. We identified 28 patients with an admission diagnosis of AH and Maddrey DF score >32, respectively 12 women (42%), 16 men (58%), the mean age was 55. All of the patients in this cohort with Maddrey DF score >32 had underlying liver cirrhosis, based on clinical and imaging data, 21 (75%) of them being classified as Child C and 7 (25%) as Child B. Results. The most frequent symptoms reported by the patients with severe alcoholic hepatitis were ascites 24 (85%), encephalopathy 20 (71%), jaundice 20 (71%), edema 17 (60%). Other symptoms were hepato-renal syndrom 4 (14%), fever 4 (14%), GI bleeding 3 (10%). The most common biological changes associated with severe alcoholic hepatitis have been: high prothrombin time – 26±1,3 s, hyperbilirubinemia – 150±32,5 μmol/l, hypoalbuminemia – 22±1,15 g/l. The patients have also presented biological features of hypersplenism: thrombocytopenia in 16 (57%) patients, leukopenia - 4 (11%), anaemia in 20 (71%) cases. Out of total 28 patients 100% patients had one or more features of liver decompensation at the time of admission. There were total of 2 deaths during the hospitalization, accounting for 7% of all patients presenting Maddrey DF score > 100 and MELD score > 40. Conclusions. In conclusion, we have identified the factors associated with severe alcoholic hepatitis and related to bad prognosis in these patients. The using of these factors has a high degree of accuracy in predicting bad prognosis and mortality in patients with alcoholic liver disease. Key words: alcoholic hepatitis, Maddrey’s discriminant function, MELD score References 1. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease, Journal of Hepatology 2018 vol. 69 2. Erik Rahimi and Jen-Jung Pan, Prognostic models for alcoholic hepatitis, Biomarker Research 2015; 3: 20. 3. Mercedes Amieva-Balmori et al., Model for end-stage liver disease-Na score or Maddrey discrimination function index, which score is best? World Journal of Hepatology. 2015 Aug 18; 7(17): 2119–2126.