It is generally believed that chronic alcohol consumption results in cerebellar atrophy and Purkinje cell loss, especially in the anterior vermal region. A post-mortem stereological design was applied to cerebella from 10 chronic male alcoholics (mean age 45.5 years) with a minimum of 10 years of severe addiction and 10 male controls (mean age 42.5 years). All alcoholics had pathoanatomical evidence of alcohol abuse but no clinical signs of Wernicke's encephalopathy. Cerebellum was divided into five different areas: the anterior and posterior lobe, the anterior and posterior vermis, and the flocculonodular lobe. The total cortex and white matter volume, the cerebellar surface area, the total Purkinje and granule cell number and density, and the mean volume of Purkinje cells and their cell nuclei were measured in all five regions using stereological methods. The volume of the granular layer was increased by 13% with an increase in layer thickness by 17% possibly due to oedema. Globally, the mean volume of the Purkinje cell perikaryon was decreased by 24% with a decrease in the volume of Purkinje cell nuclei by 16%. The increase of the granular layer and the decrease of Purkinje cell size resulted in a 21% global reduction of Purkinje cell density without a concomitant loss of neurons. No significant regional or global cortical and white matter atrophy was found in cerebella from alcoholics compared to controls.