In supporting prior reviews, this study found that injured patients were more likely to measure positive for blood alcohol concentration (BAC) at the time of the ER visit and to report drinking prior to injury compared with noninjured ER patients. The magnitude of the link between alcohol use and injury increased significantly for violence-related injuries compared to injuries unrelated to violence. Indicators of alcohol-use disorders did not show a strong link with injury. The findings were not consistent across studies, however, and some contextual variable, including study-level detrimental drinking pattern, explained some of the variation. This review involved a broader range of ER studies than previously reported reviews, across both developed and developing countries. Future research on alcohol-use and injury should focus on obtaining representative samples of ER patients, with attention to both acute and chronic alcohol use. Future research should also identify organizational and sociocultural variables that may influence findings across studies. In-depth patient interviews may also be useful in gaining a better understanding of the role of drinking in an injury event. A computerized search of the English-language literature on MEDLINE, PsychINFO, and the National Institute on Alcohol Abuse and Alcoholism Alcohol and Alcohol Problems Science Database was conducted to find articles published between 1995 and 2005. The following key descriptors were used in the search: "emergency room/emergency department/accident and emergency;" "alcohol/drinking;" and "injuries (intentional and unintentional)." 4 tables, 1 figure, and 56 references