With the availability of non-alcoholic beer, many patients are substituting non-alcoholic beer for regular beer. Moreover, several clinicians advocate the use of non-alcoholic beer by alcoholics when there is a possibility of relapse. However, patients with alcoholic end-stage liver disease can accumulate substantial circulating ethanol levels even when they consume non-alcoholic beer. We present a case of a patient with end-stage liver disease who achieved a blood alcohol level of 57 mg/dL after drinking non-alcoholic beer.