OBJECTIVE To address the prospective association between alcohol drinking pattern and all-cause mortality. METHODS Population-based cohort study conducted between 1993 and 2003. METHODS Denmark. METHODS A total of 26 909 men and 29 626 women aged 55-65 years. METHODS We obtained risk estimates for all-cause mortality for different levels of quantity and frequency of alcohol intake adjusted for life-style factors, including diet. RESULTS During follow-up, 1528 men and 915 women died. For the same average consumption of alcohol, a non-frequent intake implied a higher risk of death than a frequent one. CONCLUSIONS Drinking pattern and not just the total amount of alcohol consumed is important for the association between alcohol intake and mortality. These results suggest that future public guidelines concerning sensible alcohol drinking should include messages about drinking pattern together with quantity of alcohol.