There is undisputed evidence linking alcohol consumption and violence and other forms of aggressive behaviour, and also linking aggression with dysfunction of the brain indolylamine serotonin (5-hydroxytryptamine or 5-HT). Alcohol consumption also causes major disturbances in the metabolism of brain serotonin. In particular, acute alcohol intake depletes brain serotonin levels in normal (non-alcohol-dependent) subjects. On the basis of the above statements, it is suggested that, at the biological level, alcohol may induce aggressive behaviour in susceptible individuals, at least in part, by inducing a strong depletion of brain serotonin levels. In this article, evidence supporting these interrelationships and interactions will be summarized and discussed, the alcohol serotonin aggression hypothesis will be reiterated, and potential intervention strategies will be proposed.