Objective. —To examine women's access to treatment for alcohol problems in terms of the prevalence, characteristics, and treatment-seeking patterns of problem drinkers in a range of alcohol-specific and nonspecialized health care systems. Design. —In-person survey. Setting. —A Northern California county. Participants. —Consecutive samples of admissions in public alcohol treatment (n=381), drug treatment (n=210), mental health treatment (n=406), emergency health services (n=2626), primary health clinics (n=394), and adults in the county general population (n=3069). Primary Outcome Measures. —Prevalence and relative risk (RR) of problem drinking and rates of alcohol-related treatment episodes. Results. —Rates of problem drinking were higher among men than women across all samples. However, after accounting for gender differences in general population rates, women in all of the non-alcohol-specific clinical samples were at greater risk than men for problem drinking (eg, RR=5.6 for women and RR=2.1 for men in the mental health sample). Men reported a greater variety in types of services sought in past alcohol-related treatment encounters, but women experienced greater symptom severity. Conclusions. —Female problem drinkers were more likely than male problem drinkers to use non-alcohol-specific health care settings, particularly mental health treatment services, and to report greater symptom severity. Future research on women's access to services for alcohol problems should consider a range of health care systems and gender differences in seeking help. (JAMA 1992;268:1872-1876)