The aim of this study was to evaluate the prevalence, behavioral patterns and correlates of regular alcohol drinking in high school students. This cross-sectional study involved the completion of a modified version of "Health Behavior in School Age Children" (HBSC 1997/1998) questionnaire by 4,153 grade 9-11 students from 26 randomly selected high schools in Istanbul. Chi-square test, Spearman correlation test and forward stepwise multiple logistic regression model were used for statistical analyses as appropriate. Overall, 61% of students were experimental drinkers, and 46% of the students were current drinkers. There was a significant difference between female and male students with respect to reporting current alcohol drinking at grade 9 and 11 (p > 0.05 for each comparison). Regular drinking was reported by 6% of students. Male students were more likely than female students to report regular drinking at each grade (p < 0.01 for each comparison). Nineteen percent of the students reported that they had been really drunk at least once during their lifetime. Malestudents were more likely than female students to report an occasion of drunkenness at each grade (p < 0.05 for each comparison). All types of drinking behavior rates tended to increase across grades for both genders (p < 0.05 for each comparison). In logistic regression analysis the following were all independently associated with regular drinking: being in grade 11, smoking cigarettes currently, lifetime drug use, bullying others, being sexually active, playing computer games > or = 4 h/week, exercising < or = 1 h/week, spending > or = four evenings with friends, at ease in talking to same gender friends, tiredness in the morning, perceived as good-looking/beautiful, higher educational level of the mother and perceived poor academic achievement. The results of this study showed that alcohol consumption is prevalent among high school students. There is therefore a need for school-based alcohol prevention programs which also deal with family and peer influences on drinking.