OBJECTIVE To evaluate the effects of changes in aggregate alcohol consumption on fatal motor vehicle traffic accidents, accidental falls, and other accidents in 14 western European countries after 1950, and to compare traditional beer, wine and spirits countries. METHODS The countries were sorted into three groups. Gender-specific, age-adjusted annual mortality rates (15-69 years) were analysed in relation to per capita alcohol consumption, utilizing the Box-Jenkins technique for time series analysis. All series were different to remove long-term trends. The results of the analyses of individual countries were pooled within each group of countries to increase the statistical power. METHODS Overall accident mortality data for 5-year age groups were converted to age-adjusted mortality rates for the age group 15-69 years, using a European standard population. Data on per capita alcohol consumption were converted to consumption per inhabitant 15 years and older. RESULTS For male accidental falls, the analyses uncovered a statistically significant association with alcohol consumption in northern and central Europe, but not in southern Europe. Among females the association was insignificant in all regions. For male traffic accidents, significant relationships were uncovered in central and southern Europe, but not in northern Europe. Among females the effect was significant only in central Europe. For the remaining fatal accidents a significant relationship was found for north European males only. CONCLUSIONS The association between aggregate alcohol consumption and rates of fatal accidents is mainly due to traffic accidents in central and southern Europe, and to falls and other accidents in northern Europe.