Alcohol is a substance that has profound effects on individuals, society, and the economy. Its use among adolescents and young people in Sub-Saharan Africa (SSA) is a growing concern. This chapter examines the prevalence of alcohol consumption, and the risk factors associated with it, and discusses the potential consequences of adolescent alcohol use in SSA. Thereafter, recommendations that emphasise the implementation of strategies aimed at mitigating risk factors and bolstering protective factors to prevent alcohol use are highlighted, including the role of evidence-based interventions at individual, family, health care, and community levels that are tailored to the local context. Multiple stakeholder approaches that draw upon a community coalition model have been successful in addressing adolescent alcohol and drug use, including some in Africa are recommended.