The misuse and abuse of alcohol is widespread in South African society and is likely to have a large impact on the economy. A major burden is borne by the hospital care system, in particular the cost of alcohol-related trauma. The purpose of this study was to estimate the cost of alcohol misuse in terms of fatal and non-fatal trauma. The design of the study was a cross-sectional survey of key informants. Each key informant was mailed a list of 11 trauma categories found to be linked to alcohol in both the local and international literature. They were asked to make an estimate of the alcohol attributable fraction (AAF) for each trauma category, based on their clinical experience and knowledge of empirical research. The median estimates for each trauma category showed that alcohol misuse could be linked to a substantial amount of mortality and morbidity, particularly with respect to motor vehicle trauma and interpersonal violence. These AAF estimates were supported by the findings of other empirical research conducted in South Africa, as well as by the literature on mortality data in the U.S.A. This suggests that there is potential for a vast amount of injuries and deaths to be eliminated if alcohol misuse could be controlled or eliminated.