BACKGROUND Excessive alcohol consumption is a well-recognized factor contributing to premature morbidity and mortality. METHODS This retrospective, matched cohort study was designed to assess the attributable effects of excessive alcohol consumption on outcome in patients undergoing noncardiac surgery. All data of 28,065 patients operated at a tertiary care university hospital were recorded with a computerized anesthesia record-keeping system. Cases were defined as patients with history of excessive alcohol consumption (>30 g alcohol per day). Controls were selected according to matching variables in a stepwise fashion. RESULTS In our data set, 928 patients (3.3%) were found with a history of excessive alcohol consumption. Matching was successful in 897 patients (97%). The crude mortality rates for the cases were 1.3% and 1.6%, for the matched controls (P=.084, power=0.85). Prolonged length of hospital stay was observed in 38% versus 33% (P=.013, power=0.50), admission to the intensive care unit was deemed necessary in 11% versus 9% (P=.027, power=0.55), and intraoperative cardiovascular events were detected from the database in 22% versus 21% (P=.053, power=0.61). CONCLUSIONS In this study, history of excessive alcohol consumption alone is not a factor leading to an increased perioperative risk in noncardiac surgery.