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Background: To estimate the prevalence of changes in the frequency of self-reported heavy episodic drinking (HED) among drinkers in Latin America and Caribbean countries on alcohol consumption during the COVID-19 pandemic, and to assess self-reported factors associated with the increased frequency of HED., Methods: Data from 12,328 adults who responded to the cross-sectional survey conducted in 33 countries of Latin America and the Caribbean by Pan American Health Organization were used. Logistic regression analyses were performed to estimate the effect of the sociodemographic characteristics, quarantine practices, and anxiety symptoms on the increase in frequency of HED among the 2019 drinkers., Results: 65 % of drinkers in 2019 self-reported HED during the COVID-19 pandemic with 13.8 % of the drinkers reporting an increase in HED compared to a 33.38 % decrease in HED. Multivariable analysis indicated that male gender (aOR 1.29, 95 %CI 1.13; 1.49), higher income (aOR 1.64, 95 %CI 1.35; 1.99) and higher level of quarantine practices (aOR 1.10, 95 %CI 1.04; 1.16) were positively associated with increased frequency of HED; unemployment (aOR 0.78, 95 %CI 0.64; 0.96), student status (aOR 0.53, 95 %CI 0.43; 0.64) and living with children (aOR 0.91, 95 %CI 0.84; 0.99) were negatively associated with increased frequency of HED. A gradient of association was found between generalized anxiety disorder and an increase in HED frequency during the pandemic., Conclusion: Along with other measures to decrease the spread of COVID-19, it is important to include measures to reduce alcohol consumption and address mental health conditions in the national response to the pandemic., (Copyright © 2021 Elsevier B.V. All rights reserved.)