The etiology of alcoholism is under constant revision. This work critically examines the accumulated evidence on the degree of genetic determination of alcoholism, aiming to provide an updated view of the problem. The methodological aspects of studies performed in families, twins and adopted siblings are analyzed. The associations of alcoholism with genetic markers and diseases are reviewed, including the negative correlation between alcoholism and an aldehyde dehydrogenase variant in Japanese subjects. The association between marker genes, specially the HLA system, with organic damage and the future projection of these studies are mentioned.