The major objective of this study was to compare trends in three types of fatal injuries associated with alcohol use among youth under the legal drinking age and among adults of legal drinking age from 1990-1998. The fatal injuries investigated included homicide, suicide, and motor vehicle-traffic deaths. Results were: (1) motor vehicle-traffic deaths and homicide were higher among youth under the legal drinking age than among adults of legal drinking age; whereas, suicide was more common among adults of legal drinking age than among youth under the legal drinking age; and, (2) African American, Hispanic, and American Indian male youth under the legal drinking age were at substantial risk of being victims of homicide and motor vehicle-traffic deaths.