BACKGROUND Physicians who have healthy lifestyles can provide quality healthcare to their patients and keep themselves healthy. There is little data on the prevalence of drinking behaviors and problems among East Asian medical students. Here, we explored alcohol use and drinking motives among medical students in Korea. MATERIAL AND METHODS A questionnaire-based, multicenter, cross-sectional study was carried out in 323 students from 5 medical colleges in Korea between July and October 2016. We used the Korean version of the Alcohol Use Disorders Identification Test (AUDIT) and an anonymous, self-administered questionnaire that included demographic characteristics, smoking status, consumption of alcohol, and drinking motives. RESULTS The mean AUDIT score was 9.8±7.5 for males and 6.3±5.4 for females. Heavy drinking (75.9%) and binge drinking (56.0%) were very high among Korean medical students. Female medical students drank as much as male students, and much more than other women. The probability that a student would be a binge drinker was 2.72 times higher for a smoker than a non-smoker. The scores for drinking frequency, alcohol intake at one time, heavy drinking, binge drinking, and alcohol dependence symptoms were highest in the group who had "enhancement drinking motives". CONCLUSIONS Heavy drinking and binge drinking are common among both male and female medical students in Korea and this behavior is associated with smoking and enhancement drinking motives. Medical schools should consider implementing effective interventions to prevent and reduce problem drinking among medical students.