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The aim of this cross-sectional study was to determine the prevalence of alcohol problems among adult somatic in-patients in urban hospitals of Naples. The patients were screened with a structured questionnaire regarding life style. After discharge, the patient records were examined and the hospital discharge diagnoses were registered. A patient was considered having an alcohol problem if one or more of the following criteria were fulfilled: (1) a Michigan Alcoholism Screening Test score at or above five; (2) a self-reported daily consumption for at least 2 years of at least 60 g of ethanol for males and 36 g for females; (3) an alcohol-related discharge diagnosis. The prevalence of patients with alcohol problems was significantly (P < 0.01) higher among male (43.8%, 95% confidence limits, 37.6-50.2%) than among female patients (14.8%, 95% confidence limits, 9.6-21.4%). There were no significant differences among the different types of somatic departments regarding the prevalence of alcohol problems when gender was considered. Patients with alcohol problems differed significantly from those without alcohol problems regarding a number of variables: the former drank significantly more alcohol, smoked for more years, and had a higher prevalence of alcohol problems in the family. It is concluded that alcohol problems among in-patients are as prevalent in Naples as in other industrialized countries, that it is often not registered among discharge diagnoses, and that the problems are more prevalent in males than in females, irrespective of the type of department.