Trauma is one of the leading causes of morbidity and mortality in the U.S. and alcohol makes a significant contribution to this problem. Alcohol has been demonstrated to increase the incidence of trauma through its ability to alter behavior and impair motor performance. Its effect on the severity of trauma has been more controversial. This study examines the impact of acute intoxication on injury severity by retrospectively reviewing 12 months of trauma admissions (n = 1957) to a Level I trauma center for Injury Severity Score, mortality rate, discharge destination and length of hospital stay. When intoxicated versus non-intoxicated patients were compared, no differences were found in ISS, mortality, or incidence of being discharged to home. However, length of stay was significantly shorter for intoxicated patients. This study supports the concept that acutely intoxicated trauma victims suffer as many consequences as non-intoxicated patients, with the exception of length of stay. A discussion of these findings along with other reports on injury severity and alcohol use is included at the end of the paper.