Previous studies have suggested that beta blockers might be useful in the treatment of alcohol withdrawal syndrome. A randomized, double-blind clinical trial was therefore conducted to compare results with atenolol versus those with placebo in patients hospitalized with alcohol withdrawal syndrome. In addition to receiving customary therapy, patients were randomly assigned to receive atenolol (61 patients) or placebo (59 patients). Outcome was assessed daily by the measurement of nine features in three categories: vital signs, clinical signs (eg, tremor), and behavioral signs (eg, agitation). Among patients who had withdrawal symptoms at baseline, vital signs became normal more rapidly in the patients receiving atenolol; abnormal behavior and clinical characteristics also resolved more rapidly. On each treatment day, significantly fewer patients receiving atenolol required concomitant oxazepam therapy for agitation. Patients receiving placebo, however, required a significantly higher mean daily dose of oxazepam. The results indicate that atenolol is helpful in the treatment of patients with alcohol withdrawal syndrome.