OBJECTIVE: To assess the role of alcohol in downhill skiing injuries. DESIGN: Comparison of alcohol consumption habits and blood alcohol concentrations of injured skiers to those of randomly selected controls. MATERIALS AND METHODS: 121 injured skiers and 701 control subjects were interviewed and gave breath samples for the determination of blood alcohol concentration. MEASUREMENTS AND MAIN RESULTS: Neither mean blood alcohol concentration nor the number of subjects with an intoxicating level of alcohol in blood (> 0.5 g/L; 2.9% of control subjects and 3.3% of the injured patients) differed significantly between the groups. Also, the severity of the injury and the blood alcohol concentration seemed to be independent of each other; all of the most severe traumas occurred in subjects with no detectable alcohol in blood. CONCLUSIONS: Alcohol does not seem to be a major etiological factor in skiing-related injuries.