BACKGROUND: The transition to studying at university is associated with increased levels of both stress and hazardous alcohol use. The aim of this study is to investigate the influence of these factors on first-year dropout from university studies. METHODS: Two complete cohorts of university freshmen at two homogeneous universities, one in the north and one in the south of Sweden, were asked to participate in an intervention study. Participants responded to a baseline questionnaire including measures of stress and alcohol use. Official university records showing dropout over 12 months were collected. RESULTS: A multivariate analysis established that high stress and admission to the northern university were associated with dropout from university studies, while symptoms of depression and anxiety as well as hazardous drinking were not. CONCLUSIONS: There is a need to address the issue of stress associated with the start of university studies. It seems important to offer stress-reducing interventions, specifically aimed at reducing transitional stress, as soon as students start university.