OBJECTIVE To describe current screening and intervention practice for alcohol problems in a New Zealand trauma centre. METHODS Retrospective analysis of a trauma registry database at a metropolitan hospital in New Zealand, and hospital chart review for documentation of alcohol screening and intervention on a random sample of 120 adults, stratified by ethnicity and blood alcohol status, admitted following unintentional injury for the period January 2003 to December 2004. RESULTS Among 1970 patients admitted following unintentional injury during the study period, 23% had a blood alcohol test at admission. Approximately half of these tests were positive. While 68% of charts reviewed included a general comment on alcohol use, only 7.3% recorded information that suggested a possible drinking problem. No formal alcohol screening interviews were documented, and in only 1.5% of admissions was an alcohol intervention in the hospital setting recorded. CONCLUSIONS Formal screening and interventions for alcohol problems among this group of inpatients were infrequent, indicating missed opportunities to reduce alcohol-related harm and, potentially, trauma recurrence. Effective approaches for alcohol screening and intervention in the New Zealand trauma inpatient setting require review.