In 1987, we began a longitudinal study of the offspring of alcoholic parents and have been following this group of young adults from their freshman year in college throughout their transition into later young adulthood. The goal of this review is to highlight some of the findings we consider most important and relevant to the development of pathological alcohol involvement in young adulthood. Courses of pathological alcohol involvement in young adulthood are outlined. Predictors of both the development and course of pathological alcohol use in young adulthood are also addressed, including family history of alcoholism, personality, alcohol use motivations, and role transitions. While certainly a problem in its own right, pathological alcohol involvement can also affect the attainment of important life tasks and success in various life roles. Consequently, we also examine the effects of pathological alcohol involvement on later role transitions and role attainment. Finally, prevention, policy, and treatment issues surrounding this stage of life are discussed.