Binge drinking, commonly defined as consuming five or more standard drinks per occasion for men and four or more drinks for women, typically begins in adolescence. Adolescents, although they may drink less often, tend to consume higher quantities of alcohol per occasion compared with adults. This developmental difference in pattern of alcohol consumption may result, in part, from maturational changes that involve an adolescent-specific sensitivity to certain alcohol effects and greater propensity for risk-taking behaviors, such as binge drinking. Adolescent binge drinking is associated with a range of acute alcohol-related harms, some of which may persist into adulthood. The prevalence of binge drinking, including high-intensity drinking (i.e., 10 or more and 15 or more drinks per occasion), has declined among adolescents in recent years. Overall, however, the proportion of youth who engage in binge drinking remains high. This article reviews the definition and prevalence of binge drinking in adolescence, trajectories of binge drinking and their correlates, and implications for prevention.