This study investigated the relationship between age of first drink (AFD) and a broad range of negative alcohol-related outcomes among college students exhibiting unhealthy alcohol use. We conducted an anonymous on-line survey to collect self-report data from first-year college students at a large northeastern university. Among 1,792 respondents who reported ever drinking, 14% reported an AFD before age 14. These early onset drinkers were more likely than later onset drinkers to report frequent drinking, heavy drinking, and other unhealthy alcohol use behaviors. Among the subset of drinkers with unhealthy alcohol use (36%), early drinkers were more likely than later onset drinkers to report experiencing five out of 13 alcohol-related consequences, including driving while intoxicated, missing work or school due to drinking, getting into trouble at work or school due to drinking, receiving lower grades than they should have due to drinking, and developing a tolerance to alcohol. (Contains 3 tables.)