The study found that in 2008 an estimated 188,981 alcohol-related ED visits involved patients ages 12 to 20; this accounted for 32.9 percent of drug-related ED visits involving this age group. Of these alcohol-related ED visits, 70.0 percent involved alcohol only, and 30 percent involved alcohol in combination with other drugs. Of the alcohol-related ED visits for this age group, 19.1 percent had evidence of follow-up care. For this study, follow-up care is defined as "admission to an inpatient unit in the hospital, transfer to another health care facility, or referral to a detoxification program or substance abuse treatment." When ED visits involved alcohol only, 12 percent evidenced follow-up care; however, when cases involved alcohol in combination with other drugs, 35.5 percent evidenced follow-up care. This pattern held for age groups and genders. The study findings indicate that underage drinking is a costly public health concern that requires continued efforts to prevent and intervene to reduce underage drinking. ED contacts provide a unique opportunity for identifying and intervening with underage drinkers, particularly those at greatest risk for severe long-term consequences of alcohol abuse. Data for this study were obtained from the Drug Abuse Warning Network (DAWN), which is a public health surveillance system that monitors drug-related ED visits in the United States. 1 table, 3 figures, and 7 notes