Deaths and injuries due to road-crash involvement are a major health and safety problem, especially among youth. Numerous factors can account for the overrepresentation of young drivers in road crashes and one of these--alcohol--has received renewed attention. This paper examines evidence pertaining to drinking and driving among youth to determine the extent to which alcohol has special significance for crashes involving young drivers. Three sets of studies are reviewed: those providing data on the extent of drinking and drinking-driving among youth, those that examine alcohol use among youth involved in road crashes and those that estimate the relative risk of a road crash for young drinking drivers. Findings show that frequent and heavy alcohol consumption among teenagers and young adults is not unusual, although they are less likely than older age groups to drive after drinking. Nonetheless, those young people who drive after drinking have a greater risk of crash involvement than older drinking drivers at all blood alcohol concentrations. One explanation of this finding assumes that young people are "inexperienced" with drinking and with driving. Limited behavioural research done to date supports some but not all assumptions implicit in this reasoning. There is also evidence in favour of an alternative hypothesis, namely, that the comparatively higher crash-risk among young drinking drivers is attributable to a subset of this group, those that engage in risky driving behaviour and who also happen to use alcohol. Further investigation into the personal and social characteristics of young people who drive after drinking would provide a sounder empirical basis for policies and programmes to reduce crash involvement among youth.