<h4>Aim</h4>To evaluate the impact of multiple apical periodontitis (AP) on the expression of TLR4/NF-κB pathway components, proinflammatory cytokine levels, and development of hepatic injuries in rats with and without chronic alcohol consumption.<h4>Methodology</h4>Thirty-two rats were assigned to four groups (n = 8): Control, AP, Alcohol, and Alcohol+AP. This evidence concerns the gene TLR4 and periapical periodontitis.