The purpose of this study is to provide an updated estimate of the social and economic costs of alcohol use to Australia in recognition of the: length of time since the last substantive national estimate (Collins and Lapsley, 2008); growing evidence for alcohol as a cause of disease and injury; reinterpretation of previous evidence using new methods in relation to the purported ‘protective’ effects of alcohol on chronic disease risk; new Australian guidelines to reduce health risks from drinking alcohol (National Health and Medical Research Council, 2020); and, changing patterns of alcohol consumption in Australia. The most recent and complete harm and economic data available were applied to quantify costs incurred during the 2017/18 financial year.