The number of violent crimes has increased substantially over the past decade with an associated increase in injury-related mortality. The influence of alcohol intoxication on accidents involving motor vehicles has been investigated extensively, but few studies have examined the influence of alcohol and drug intoxication on life-threatening assaults. This study examined the correlation of alcohol intoxication with life-threatening victimization by penetrating torso trauma. Retrospective evaluation of patients presenting with penetrating nonmissile anterior torso trauma to an urban Level 1 trauma center between January 1988 and December 1991 was performed. Serum ethanol levels and urine toxicology studies were assessed at initial presentation for all patients. Sixty-two patients with anterior abdominal stab wounds were evaluated, of which 51 (82%) were male. Ethnic distribution paralleled that of the surrounding community, with 50 (81%) African-American, 8 (13%) Latino, and 4 (6%) white patients. The mean age was 32 years. Fifty-two (84%) patients tested positive for alcohol, with 39 (63%) having serum levels of ethanol above the legal intoxication limit. Twelve (19%) patients tested positive for cocaine on urine toxicology screen. Polysubstance use was evident in 10 (16%) patients with positive test results for both alcohol and cocaine. These data demonstrate a strong correlation between alcohol use and life-threatening assaults.