Drinking pattern seems to be an important mediator of the alcohol-violence association. Aggregate level studies have demonstrated that the alcohol-violence association is stronger in countries where intoxication occurs relatively more frequent to the overall drinking. However, this has not been tested against empirical data at the individual level or with respect to violence among young people. Thus, the aim of this study was to test whether the association between alcohol consumption and prevalence of alcohol-related aggression in young people would be stronger in countries where intoxication is relatively more prevalent. The data comprised school surveys (pupils at age 16) from 13 countries in the European School Survey Project on Alcohol and Other Drugs 2003. The countries were divided into high, medium, and low levels of intoxication rate. The prevalence of alcohol-related aggression varied considerably across countries, and was significantly higher in drinking cultures where intoxication is relatively more prevalent. The findings of this study suggest that challenges for prevention of acute alcohol-related harms in young people may be larger in countries where adolescents to a larger extent drink to intoxication. From a prevention point view, it also seems warranted to direct more future studies into the area of potential for preventing intoxication and drunkenness, not in the least among young people. Tables and references (Published Abstract)