Underage use of alcohol is a large and increasing problem in Eastern Europe. The objective of this comparative study is to examine the effects of family-related factors on youth alcohol consumption in three East-European countries (Estonia, the Czech Republic, and Hungary). Data on alcohol use and risk factors were drawn from the International Self-Report Delinquency Study (ISRD-2). Using binary logistic regression, it was found that in all three countries, adolescents with stronger parental supervision were more likely to be abstinent and less likely to be involved in heavy episodic drinking than those with weaker supervision. Parental bonding had similar positive effects regarding abstinence in Hungary and the Czech Republic but not in Estonia. In the Czech Republic, adolescents living in single-parent households were less involved in heavy episodic drinking, whereas affluence increased heavy episodic drinking. This effect is not found for Hungary and Estonia. Adolescents in Estonia who experienced more negative life events were more involved in heavy episodic drinking; this was not so for the other two countries. We conclude that family social control is a universal protective factor in decreasing alcohol use in these three Eastern European countries; concerning the other factors, the results were more mixed.