University/college can be a challenging time as students face developmental tasks such as building new social networks and achieving academically. Social anxiety may be disadvantageous in this setting given that social situations often include drinking and individuals with social anxiety tend to self-medicate through alcohol use. However, findings are mixed as to whether the association between social anxiety and alcohol use is positive or negative. To clarify the nature of this association, we used a person-centered longitudinal analysis to identify student groups based on levels of social anxiety symptoms and alcohol consumption. Undergraduates (N = 1,132, 70.5% female, M[subscript age] = 19.06 at Time 1) enrolled in university completed a survey assessing social anxiety and alcohol use over 3 years, and psychosocial functioning and emotion coping behaviors at Time 1. Two out of 5 groups were identified with higher levels of social anxiety, 1 with moderately low alcohol use, and the other with moderately high alcohol use. Both groups reported higher levels of general anxiety, depressive symptoms, behavioral inhibition, emotional reactivity, daily hassles, and lower levels of social ties at Time 1 than the 3 groups with lower levels of social anxiety. Furthermore, the social anxiety-alcohol use group reported significantly lower academic grades and was more likely to endorse problematic emotion coping behaviors (e.g., self-injury) than the social anxiety-low alcohol use group. These results not only help explain the mixed findings in the literature but indicate that 1 group of socially anxious students may be particularly vulnerable to negative adjustment difficulties.