Alcohol consumption is one of the risk factors for colorectal cancers and adenomas. Since alcohol dehydrogenase is a key enzyme in alcohol metabolism, it may thus play a role in colorectal carcinogenesis. The present study was conducted to assess the association of a functional ADH1B Arg47His polymorphism with colorectal adenomas in a case-control study of male officials in the Self-Defense Forces who received a pre-retirement health examination at two Self-Defense Forces hospitals. The study subjects comprised 455 with colorectal adenomas and 1,052 controls without polyps, all of whom underwent total colonoscopy. Statistical adjustment was made for age, hospital, Self-Defense Forces rank, body mass index, cigarette-years, and alcohol consumption. There was no measurable association between the ADH1B Arg47His polymorphism and colorectal adenoma development. The adjusted odds ratio for individuals with the 47His/His genotype compared to those with individuals with 47Arg alleles was 1.18 (95% confidence interval 0.94-1.49). There was no influence of the level of alcohol consumption (interaction P = 0.84). In addition, there were no clear interactions of the ADH1B with ALDH2 Glu487Lys and MTHFR C677T with regard to the risk of colorectal adenoma. In conclusion, the present study suggested that the ADH1B Arg47His polymorphism does not contribute to the risk of colorectal adenoma in any subgroup of middle-aged Japanese men defined by alcohol drinking, as well as the ALDH2 Glu487Lys and MTHFR C677T genotypes.