OBJECTIVE This study examined prevalence and predictors of alcohol consumption and alcohol problems in a sample of medical students in Vietnam. METHODS A cross-sectional survey using a multi-stage cluster sampling approach was conducted in 2007 in two universities in Vietnam. The students (n = 619, 100% response rate) completed questionnaires based on the Alcohol Use Disorder Identification Test. A score of >or=8 defined presence of alcohol problems. Data analyses adjusted for the cluster sampling approach. RESULTS Overall 65.5% of students had drunk alcohol during the previous year while alcohol problems were detected in 12.5%. Male students, students who reported that their family members drank and students who reported that their flat mates were drinking were more likely to be current drinkers. Male students were 14.3 times more likely to have an Alcohol Use Disorder Identification Test score of >or=8 compared with female students (P = 0.005). CONCLUSIONS Intervention programs focusing on male students and their social environment are warranted. As Vietnamese society rapidly modernises prevention programs for female students may also be needed.