How do I add alias names to a table. I have a lookup csv file with over 180 entries so don't want to add them in manually

I think you want to add aliases to columns in an existing ESRI featureclass? The best way to go is probably using Python. See ESRI's documentation.

import arcpy
 
arcpy.AlterAliasName('c:/city/Boston.gdb/SnowReport', 'Snow Report')

If you want to add aliases to a new featureclass you can use this FME article.