Binge drinking, or consuming more than five alcoholic drinks on one occasion, generally results in acute impairment and has numerous adverse health consequences. Research indicates that binge drinking may be increasing in this country. The objectives of this research was to quantify episodes of binge drinking among adults from 1993 to 2001, characterize adults that engaged in binge drinking, and describe State and regional differences in binge drinking. The Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults aged 18 or older that is conducted annually in all States, was used. The sample size ranged from 102,263 in 1993 to 212,510 in 2001. The measures were binge drinking prevalence, episodes, and episodes per person per year. The results show that between 1993 and 2001, the total number of binge drinking episodes among adults increased from approximately 1.2 billion to 1.5 billion. During this time, binge-drinking episodes per person per year increased by 17 percent. Between 1995 and 2001, binge drinking episodes per person per year increased by 35 percent. Men accounted for 81 percent of binge drinking episodes in the study years. Although rates of binge drinking episodes were highest among those aged 18 to 25 years, 69 percent of binge drinking episodes occurred among those aged 26 years or older. Overall, 47 percent of binge drinking episodes occurred among otherwise moderate drinkers, and 73 percent of all binge drinkers were moderate drinkers. Binge drinkers were 14 times more likely to drive while impaired by alcohol compared with non-binge drinkers. There were substantial State and regional differences in per capita binge drinking episodes. It was concluded that binge drinking is common among most strata of adults in the United States, including among those aged 26 or older. Per capita binge-drinking episodes have increased, particularly since 1995. Binge drinking is strongly associated with alcohol-impaired driving. Effective interventions to prevent the mortality and morbidity associated with binge drinking should be widely adopted, including screening patients for alcohol abuse. 2 figures, 3 tables, 53 references