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In a recent issue of <jats:italic>The Journal of Pathology<\/jats:italic>, Ferrer\u2010Curriu, Guitart\u2010Mampel <jats:italic>et al<\/jats:italic> investigated FGF21 in alcoholic cardiomyopathy (ACM). They showed that FGF21 deficiency aggravates alcohol\u2010induced cardiac damage and dysfunction by exacerbating mitochondrial alterations, oxidative stress, and lipid metabolic dysregulation, suggesting FGF21 as a promising therapeutic agent in ACM. Paradoxically, FGF21 cardiac and circulating levels correlate with cardiac damage and oxidative stress in patients with ACM, pointing to FGF21 as a potential biomarker of alcohol\u2010induced cardiac damage. Further studies are needed to address when FGF21 can be used as a diagnostic biomarker and when it can be used as a therapeutic agent to treat ACM. \u00a9 2021 The Pathological Society of Great Britain and Ireland. 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