The authors explored the clinical significance of the DSM-III distinction between alcohol abuse and alcohol dependence by studying 403 male primary alcoholics consecutively admitted to an inpatient alcohol treatment program. On intake, 186 men met criteria for alcohol abuse and 217 met criteria for alcohol dependence. The two groups were virtually identical except that subjects with alcohol dependence took more drinks per drinking day and had more alcohol-related medical problems and past hospitalizations. During a 1-year follow-up, men with alcohol dependence were more likely to have visited a public detoxification facility. The results do not support prognostic implications for the differentiation between alcohol abuse and alcohol dependence in alcoholic inpatients.