Alcohol is metabolised by the liver and this organ may be consequently damaged resulting in serious impairment of normal hepatic structure and function. Nearly all the physiological systems of the body are adversely affected by alcohol to varying degrees and the behavioural effects observed with intoxication are associated with compromised neurotransmitter functions in the brain and altered brain structure in the long term. Adverse consequences of alcohol intake may be evident in other systems including the cardiovascular, gastrointestinal, reproductive and immunological systems. There is an increased risk of atherosclerosis, cancers of the oral cavity, pancreatitis and immune system disturbances associated with prolonged alcohol intake. In pregnant women alcohol metabolism is reduced and as the developing foetus has lowered ability to metabolise blood alcohol compared to an adult there is an elevated risk of serious consequences associated with foetal alcohol syndrome. Despite the nearly overwhelming negative consequences of alcohol intake, the beneficial effects of drinking red wine linked to lowered heart disease despite a high fat diet (the ‘French Paradox’) may be associated with the antioxidants and other polyphenols also found in non-alcoholic red grape juice. Serious consideration of the effects of alcohol on the body should inform decisions on the intake of alcohol.