Objective: This study examines factors potentially associated with the receipt of alcohol treatment services among a large sample of American Indian adolescents. Method: Data for this study were drawn from the Voices of Indian Teens project, a 5-year, longitudinal project involving school-based survey data collection at 10 primarily American Indian schools. In November 1992 a total of 2,077 American Indian youths in grades 9 through 12 completed self-report surveys. Of these, 1,681 had a complete set of data for these analyses. Three logistic regression models were developed to predict the probability of (1) receipt of treatment, (2) treatment recommendation, and (3) receipt of treatment among those teenagers who received a treatment recommendation. Results: The probability of an individual receiving treatment was 15 times greater if treatment was recommended. Treatment recommendation mediated the relationship of several measures of psychological distress and alcohol use, abuse, and dependence with actual treatment. Conclusions: Recommendation for treatment is strongly associated with receiving treatment. Community education about the risks, signs, symptoms, need, and mechanisms for obtaining treatment of alcohol abuse among youths might help alcohol-abusing individuals receive the help they need.