This study focuses on a vulnerable group of pupils often missed by mainstream school surveys. It explores alcohol use and alcohol-related problems for a sample of truants of secondary school age, comparing behaviours with a school-based sample from the same geographical area. Analyses are based on a survey among truants (n = 107) and a school survey (n = 3702) undertaken in Bergen, Norway. When compared with mainstream pupils, the truants reported an earlier alcohol debut and a higher frequency of drinking. They reported significantly higher levels of binge drinking (6+ units). Truants were four times more likely to report regular drunkenness and twice as likely to report problems associated with their alcohol consumption. In the truancy sample, boys were more likely to engage in regular and excessive drinking, while girls reported higher levels of problems linked to their drinking. Results suggest that higher levels of truancy were related to more frequent drinking, drunkenness and alcohol-related problems. There are strong indications for early intervention activities directed at truants, and registration of truancy in itself could be a simple and effective way of identifying pupils at risk of a wide range of social and health problems, including high levels of alcohol use.