The objective of this study was to examine patterns and yearly trends in alcohol-related hospitalization rates during the period 1987/88-1995/96 for men and women living in metropolitan and rural/remote Victoria. Alcohol-related hospitalizations were extracted from the Victorian Inpatient Minimum Dataset (VMD) for the years 1987/88-1995/96 (public hospitals) and 1993/94-1995/96 (private hospitals), and adjusted by the appropriate aetiological fractions. Sex-specific age-adjusted rates we expressed per 10000 residents/year. During 1993/94-1995/96, alcohol-related hospitalizations comprised 1.0% of all Victorian hospitalizations (about 12000/year), with men accounting for over two-thirds of alcohol-related hospitalizations. Approximately half of the alcohol-related hospitalizations were for disease conditions and the other half for external cause (injury) conditions. About 80% of all alcohol-related hospitalizations were to public hospitals, with the exception of alcohol dependence (63% to private hospitals). Alcohol-related hospitalization rates were generally higher for people living in rural/remote areas compared to urban areas. During 1987/88-1995/96, the age-adjusted alcohol-related hospitalization rates in public hospitals did not change significantly for disease conditions (14.8-14.7 for men and 6.3-6.4 for women) or female external cause conditions (6.7-6.1), but decreased for external cause conditions (18.4-15.5). In private hospitals during 1993/94-1995/96, the age-adjusted alcohol-related hospitalization rates for disease conditions decreased (5.4-4.1 for men and 3.7-3.0 for women) but increased for external cause conditions (1.8-2.4 for men and 1.0-1.2 for women). These patterns and time-trends in Victorian alcohol-related hospitalizations reflect a combination of alcohol-related morbidity levels, hospital admission practices and patterns and levels of service provision. They suggest a potential need to focus on services and programmes in rural/remote Victoria.