Aims: To assess the prevalence and pattern of alcohol use in a middle-aged and elderly population in Mumbai, India. Methods: 50 220 men aged ≥45 years from the lower and lower-middle section of the general population were interviewed. Results: 18.8% were currently consuming alcoholic beverages, of whom 32.8% drank on at least 6 days per week. The most popular beverage was locally distilled ... [Show full abstract] products of fruits and grain (country liquor). Seventy-five per cent of the consumers of country liquor would consume over 53 g of ethanol on a day when they drank, with 46.6% of these doing so on at least 6 days per week. Conclusions: Abstinence, and also heavy and frequent use of alcohol, are common in this population and the latter is likely to have significant public health implications.