The World Health Organization has identified chronic alcohol consumption as one of the top ten risk factors for worldwide burden of disease. The International Agency for Research on Cancer has identified alcohol as carcinogenic to humans, including cancers of the upper aerodigestive tract, colon, liver and breast. Alcohol’s actions may be direct e.g. effects on retinoic acid and one-carbon metabolism, or indirect, through metabolites such as acetaldehyde and reactive oxygen species or through various signaling pathways that influence cell cycle and apoptosis that may contribute to carcinogenesis. This report reviews the state of the art in alcohol-related cancer research in ten chapters.