A total of 366 American Indian students in grades 7 through 12 completed the PRIDE questionnaire. Recent alcohol use was reported by 31.9% of students, whereas 26.7% reported frequent episodic heavy drinking. One in three students felt it was harmful/very harmful to use alcohol and less than half felt alcohol was easy/very easy to obtain. A series of odds ratios found perceiving alcohol as harmful and having parents and peers who disapproved of any alcohol use reduced the odds of alcohol use. Findings may be beneficial to health professionals in developing effective prevention and intervention programs for American Indian youths.