Central nervous system (CNS) infarcts were present at autopsy in 10 of 23 alcoholic patients and in 9 of 36 nonalcoholic patients. There were more males than expected in the infarct population and in the alcoholic population. Male subjects comprised the entire population of alcoholics with infarcts. In addition, a history of alcohol abuse was present in every case of cerebral infarction dying before age 75. The incidence of cardiomegaly was increased among the alcoholics. There were no differences between alcoholics and nonalcoholics in the incidence of diagnosed hypertension, moderate-to-severe coronary atherosclerosis, or adult onset diabetes. However, CNS infarction was more likely to occur at an earlier age in alcoholics than in nonalcoholics. Excessive alcohol consumption may be a risk factor in the premature development of cerebrovascular disease in males.