Introduction. Alcohol is a major cause of road injury in Australia. It was estimated that in 1997, high-risk drinking caused 418 road deaths and 7,789 hospitalisations. The average cost of a single road fatality or hospitalisation in Australia has been estimated at about $750,000 and $132,000 respectively, resulting in a total of over $1.3 billion for 1997. The purpose of this Bulletin, the second in the NAIP series is to document national and state/territory trends in serious alcohol-related road injury (resulting in death or hospitalisation) between 1990 and 1997. These trends will be compared with trends for other serious road injuries (SRIs) known to have little or no relationship with alcohol use.