Alcohol is the most commonly misused substance among youth in the United States. Underage alcohol use contributes to risky behavior, lower academic achievement, and altered brain development, and can increase the risk of future misuse. This article explored literature on underage drinking and interventions available to address the problem. Also examined were data on underage drinking in Illinois. Illinois data indicated high school students reported drinking alcohol at a slightly lower rate than the general United States population as a whole. In addition, Illinois arrests for underage drinking-related offenses have decreased in the last 15 years, especially among non-Black males.