BACKGROUND Increasing numbers of youth in need of emergency medical treatment following alcohol intoxication have been a major public health concern in Europe in recent years. Brief interventions (BIs) in the emergency department (ED) could prevent future risky drinking. However, effectiveness and feasibility of this approach are currently unclear. METHODS A systematic literature search on controlled trials including participants aged 12-25 years treated in an ED following an alcohol-related event was conducted. Additionally, a grey literature search was conducted to support findings from the systematic review with evidence from practice projects and uncontrolled trials. Data on effectiveness, acceptance, implementation and reach were extracted. RESULTS Seven randomised controlled trials (RCT), 6 practice projects, 1 non-randomised pilot study and 1 observational study were identified. Six RCTs found reductions of alcohol use for all participants. Four RCTs found effects on alcohol consumption, alcohol-related risk-behaviour or referral to treatment. Participation and referral rates varied strongly, whereas data on acceptance and implementation were rarely assessed. CONCLUSIONS Heterogeneity of study designs and effects limit conclusions on effectiveness of BIs for young ED patients following an alcohol-related event. However, the number of practice projects in Europe indicates a need perceived by practitioners to address this population.