This article summarizes content proceedings of a satellite meeting held at the 2004 Research Society on Alcoholism Annual Scientific Meeting in Vancouver, Canada. The aim of the satellite conference was to facilitate the interaction of scientists investigating the mechanisms of alcohol-mediated organ or tissue damage, and enable the discussion and sharing of new ideas and concepts that may be common in each of the organs or tissues affected by chronic ethanol consumption. The original planned program on immunity was expanded to incorporate a session on a closely related topic "Alcohol and Mitochondrial Metabolism: At the Crossroads of Life and Death" organized by Dr. Jan Hoek and Dr. Sam Zakhari. The conference was arranged into four sessions: 1) Alcohol, Cellular and Organ Damage 2) Toll-like receptors and Organ Damage 3) Alcohol and Mitochondrial Metabolism: At the Crossroads of Life and Death and 4) Hepatitis virus and alcohol interactions in Immunity and Liver Disease. The keynote address was given by Dr. Bruce Beutler from the Scripps Institute on "TLRs in Inflammation and Immunity."The Combined Basic Research Satellite Symposium entitled, "Mechanisms of Alcohol-Mediated Organ and Tissue Damage: Inflammation and Immunity and Alcohol and Mitochondrial Metabolism: At the Crossroads of Life and Death" was convened at the 2004 Research Society on Alcoholism meeting in Vancouver, BC. Session One featured five speakers who discussed various aspects of the role of the immune system in initiating or exacerbating cellular and organ damage following alcohol consumption. The presentations were (1) Innate Immune responses of Alcohol-exposed mice and macrophage-like cells following infections with Listeria monocytogenes by Robert T. Cook 2) Alcohol, cytokines and host defense by Kyle Happel 3) Decreased antigen presentation and anergy induced by alcohol in myeloid dendritic cells by Pranoti Mandrekar 4) Transcriptional regulation of TNF-alpha in human monocytes by chronic ethanol: role of the cellular redox state by Jay Kolls 5) Estrogen and gender differences in inflammatory responses after alcohol and burn injury by Elizabeth Kovacs. This session highlighted the growing information on the role of pattern recognition molecules in alcohol-mediated tissue damage or dysfunction. The new techniques and ideas presented will be helpful in future studies in this area of research, and should result in some exciting avenues of study.