Aims: To examine the socio-economic factors associated with alcohol consumption in South Africa. Design: Cross-sectional study exploring the various socio-economic factors associated with alcohol consumption in South Africa. Setting: South Africans older than 15 years across the country’s nine provinces. Participants: Adult respondents of the alcohol intensity and frequency questions in Wave 4 of the National Income Dynamics Study (NIDS) (n=28 401). Measures: Alcohol, demographic, emotional, health and neighbourhood variables. Findings: White and Mixed Heritage (referred to as ‘Coloured’ in South Africa) adults were more likely to consume alcohol, while Indian and White adults were less likely to binge drink relative to African adults. Males at greater risk of depression, and those who resided in neighbourhoods where frequent alcohol and drug abuse was common, were more likely to binge drink. Females who exercised more than three times a week were also more likely to drink and binge drink. Adults who smoked were more likely to drink and binge drink relative to non-smoking adults. Accounting for binge drinkers’ household size, average monthly household spending for binge drinkers was low, which suggests that binge drinkers under-reported household alcohol spending. There was evidence of drinking and binge drinking among pregnant women. Conclusions: Binge drinking trends related to race, gender, neighbourhood, pregnancy and household alcohol spending warrant further investigation and consideration for possible future alcohol interventions in South Africa.