Alcohol consumption is one of the major determinants of serum high density lipoprotein (HDL) cholesterol. Very few studies have examined the correlation between alcohol consumption and high density lipoprotein subclasses. It has been suggested that HDL2 is probably the fraction that is associated with reduced coronary heart disease. The current research investigated the relationship between alcohol consumption and HDL2 and HDL3 cholesterol among 234 alcoholics who were admitted for abstinence. The results indicated that the elevated serum HDL cholesterol concentrations among alcoholics were a combination of an increase in both HDL2 and HDL3 cholesterol. HDL cholesterol and HDL2 cholesterol increased with more alcohol consumption until about 450 ml of ethanol consumption per day when serum HDL cholesterol and HDL2 cholesterol decreased. HDL3 cholesterol showed a similar trend but was not statistically significant. In addition, the serum concentrations of HDL cholesterol and subclasses were positively correlated with liver enzymes. Those with alcohol-related liver disease had significantly higher HDL and HDL2 cholesterol levels than those without. Both HDL cholesterol and subclasses decreased concomitantly with the decline in liver enzymes within one month of abstinence. The possible biologic mechanisms linking alcohol drinking with HDL cholesterol through liver induction and sex hormone changes are discussed.