There is a significant amount of evidence that serotonin dysfunction, usually in the form of low cerebrospinal fluid (CSF) levels of the major serotonin metabolite 5-hydroxyindol-3-ylacetic acid (5-HIAA), is associated with violent and other forms of aggressive behavior, including self-inflicted aggression. There have been more positive than negative studies that have demonstrated blunted responses in hormone challenge tests of serotonin function in impulsive/aggressive subjects. Overall, there is overwhelming evidence of a serotonin-aggression link. This evidence has come from studies with experimental animals, studies of real-life situations that involve violence, human physiological studies, and other human studies on experimentally induced aggressive behavior. The main issue in identifying a link between alcohol use and serotonin-related aggression involves determining how alcohol influences serotonin metabolism so as to precipitate aggressive behavior. This paper presents evidence to show that acute alcohol consumption lowers brain serotonin levels, at least in normal nonaggressive individuals. The author advises that if serotonin depletion is established as a major determinant of alcohol-induced aggressive behavior, further studies could establish a laboratory screening test for this depletion and for intervention at the population level through a variety of strategies. Possible strategies are suggested. 2 tables, 2 figures, and 69 references