Monte Carlo track structure codes provide valuable information for understanding radiation effects down to the DNA level, where experimental measurements are most difficult or unavailable. It is well recognized that the performance of such codes, especially at low energies and/or subcellular level, critically depends on the reliability of the interaction cross sections that are used as input in the simulation. For biological media such as liquid water, one of the most challenging issues is the role of condensed-phase effects. For inelastic scattering, such effects can be conveniently accounted for through the complex dielectric response function of the media. However, for this function to be useful it must fulfill some important sum rules and have a simple analytic form for arbitrary energy- and momentum-transfer. The Emfietzoglou-Cucinotta-Nikjoo (ECN) model offers a practical, self-consistent and fully analytic parameterization of the dielectric function of liquid water based on the best available experimental data. An important feature of the ECN model is that it includes, in a phenomenological manner, exchange and correlation effects among the screening electrons, thus, going beyond the random-phase approximation implicit in earlier models. In this work, inelastic cross sections beyond the plane wave Born approximation are calculated for low-energy electrons (10 eV–10 keV) based on the ECN model, and used for Monte Carlo track structure simulations of physical quantities relevant to the microdosimetry of low-energy electrons in liquid water. Important new developments in the physics of inelastic scattering are discussed and their effect on electron track structure is investigated by a comparison against simulations (under otherwise identical conditions) using the Born approximation and a simpler form of the dielectric function based on the Oak Ridge National Laboratory model. The results reveal that both the dielectric function and the corrections to the Born approximation may have a sizeable effect on track structure calculations at the nanometer scale (DNA level), where the details of inelastic scattering and the role of low-energy electrons are most critical.