Background: A substantial group of adolescents and young adults engage in risky alcohol use and there is a need for alcohol prevention. The 2020 BZgA review of reviews on addiction prevention provides the best available scientific knowledge on effectiveness of prevention measures for young people., Research Question: Which approaches show preventive effects on alcohol use in different prevention settings?, Methods: A systematic literature search in June 2017 in seven international databases resulted in 28,949 hits. Inclusion criteria were a review or meta-analysis study type, a 2012-2017 publication date, a universal or selective target group, age up to 25 years, and a target behavior of alcohol consumption. Exclusion criteria were target group people with substance use disorders and target behavior risk factors. The three authors performed a systematic content analysis of 34 alcohol-related publications and assessed their methodology using AMSTAR (A MeaSurement Tool to Assess systematic Reviews). Conclusions and recommendations were framed by consensus among all authors., Results: Based on a total number of 53 conclusions on the effectiveness of alcohol prevention approaches depending on setting (family, school, college, media, health care, and community) and target group, it can be recommended - among other things - to implement family programs and parenting training, behavioral programs targeting specific personal and social skills, brief interventions with feedback, and mentoring programs. No recent reviews that investigated the effectiveness of alcohol policies at the community or national level could be identified., Conclusions: Behavioral alcohol prevention is effective. It is recommended to address specific age and target groups in different settings by using specific interventions. Consensus is needed with regard to what kind of evidence proves effectiveness of environmental prevention measures.