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Aim Early detection of alcohol-related liver disease (ALD) is vital to prevent progressive liver damage. This study assessed the effects of liver assessment including vibration controlled transient elastography (VCTE) in patients with alcohol use disorder (AUD) attending the community Glasgow Alcohol and Drug Recovery Service (GADRS).Methods Liver assessment was available for patients attending the North East (NE) GADRS for AUD. This included VCTE by FibroScan to measure liver stiffness (LSM). Two patient cohorts were studied. Cohort 1 consisted of patients who attended community GADRS between July and October 2024 and compared those who had a liver assessment with those who had not. Any cause hospital Emergency Department (ED) attendance in the year prior to and after initial ADRS review was recorded. Cohort 2 consisted of patients who attended NE GADRS between 2019 and January 2025 who had more than one liver assessment. Estimated alcohol use (UK units) in the week prior to each assessment was noted and changes in LSM were annualised. Again, ED attendance in the year prior to and after the index assessment was recorded. Results are expressed with 95% Confidence Intervals.Results In Cohort 1, 98 patients had a liver assessment group and 119 did not. In the year after assessment there was an absolute reduction in ED attendances by 37 (20%) in those who had a liver assessment compared with a fall of 5 (2%) ED attendances in those who didn’t (p < 0.001). In Cohort 2, 112 patients had had follow-up VCTE with a median interval of 0.91 (0.73, 1.10) years. The median baseline LSM was 6.2 (5.4, 7.4): 41 (36%) had a LSM >8kPa and 15 (13%) >12kPa. On comparison between those with high LSM (>8kPa) and those with low LSM (<8kPa) at index assessment, there was a reduction in follow-up LSM (-1.39 vs 0.22 kPa; p = 0.012) and alcohol use (-70 vs 0.0 units; p = 0.003) amongst high LSM patients. High LSM patients had a reduction in ED attendances by 10 (14%) compared with a rise of 16 (11%) ED attendances in low LSM patients (p < 0.001).Conclusion Detection of advanced ALD is feasible in the community using VCTE. After liver assessment, emergency hospital attendance fell compared with those who did not have a liver assessment. In those who had repeat liver assessments, the fall in ED attendance was most obvious in those with a high baseline LSM. Those with high initial LSM were also more likely to reduce their alcohol consumption and improve their LSM reading on follow-up.