ABSTRACT Chronic alcoholism is a significant health issue associated with severe liver complications, including alcohol-related liver disease (ARLD), progresses from fatty liver to cirrhosis and hepatocellular carcinoma. ARLD affects liver function and hemostasis, leading to increased mortality. This study intended to investigate the platelet proteome and detect platelet cell apoptosis via Annexin V in ARLD patients in order to identify potential biomarkers for disease progression. Twenty-three patients with ARLD were recruited, and their platelet proteins were analyzed via mass spectrometry. Approximately 441 proteins were identified, with 73 candidate biomarkers selected on the basis of clinical importance. Key proteins involved in coagulation, inflammation, and cellular interactions are highlighted. Gene ontology and STRING analyses revealed functional clusters and pathways associated with these proteins. This study identified critical platelet proteins, such as von Willebrand factor, vitronectin, and serpin family members, which play essential roles in hemostasis and liver disease pathogenesis. These findings suggest that changes in platelet proteomes could serve as noninvasive biomarkers for diagnosing, monitoring, and treating ARLD.