This study reports on patterns of alcohol use and consequences of abuse among a sample of 916 individuals with disabilities. Alcohol use patterns were analyzed in relation to demographic characteristics, disability groupings, and various consequences of abuse. The study examines specific self-reported consequences of abuse as they relate to health, family relationships, legal involvements, and work problems. Respondents with disabilities used alcohol as much as or more than the general population despite additional risk factors such as medication and health problems. Respondents reported experiencing a number of negative consequences of alcohol use. High rates for alcohol-related arrests, health problems, and family dysfunctions are discussed as are disturbingly high rates for attending work or school under the influence of alcohol and other drugs. Recommendations for rehabilitation counselors are discussed in light of the findings.