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Background: : Recent media and political attention have focused on a "rising tide" of youth violence and alcohol-related problems in Scotland. Facial injuries in Scotland are most commonly sustained as a result of interpersonal violence, and young men are a high risk group for facial injuries. Facial injuries are known to be associated with alcohol consumption but the sociodemographic determinants are not fully known., Methods: : Influences on the incidence of alcohol-related facial injuries were investigated using data on 22,417 patients between 2001 and 2006 from the Scottish Morbidity Records., Results: : Since 2001, the incidence of alcohol-related facial injuries in Scotland has declined, but the nature and scale of the problem remain considerable, with the major burden for such injuries disproportionately affecting young men from socioeconomically deprived areas., Conclusions: : The role of poverty as the major determinant of alcohol-related facial injuries has thus far not been explicitly acknowledged. Interventions to change behavior alone are unlikely to succeed unless they are supported by measures designed to improve socioeconomic circumstances and to reduce socioeconomic inequalities.