BACKGROUND: Excessive alcohol consumption is ingrained in Irish society and is known to have significant adverse health consequences, including adverse outcomes for critically ill patients. Previous assessments of alcohol-related intensive care unit (ICU) admissions were felt to have underestimated the scale of this problem. AIMS: A study was designed to objectively measure alcohol-related ICU workload. METHODS: We prospectively recorded the number of patients who were admitted to St Jamesʼs Hospital ICU as a result of alcohol misuse during a 6-month period in 2008. Admission diagnosis, Acute physiology and Chronic Health Evaluation Score 2 (APACHE 2), ICU length of stay and 30-day mortality were recorded. RESULTS: The study group occupied 16.7% of the total available ICU bed-days, experienced longer stays and higher mortality. CONCLUSION: This study adds to the data available on the scale of alcohol-related problems amongst Irish healthcare system patients. Prioritisation of primary preventative strategies is necessary.