Levels of alcohol use are high in South Africa and not much is known about women's use of alcohol when murdered. The aim of this article is to describe the patterns of blood alcohol concentration (BAC) at the time of death for female homicide victims and to explore the factors associated with having an elevated BAC. Method: A subsample of a national, representative, retrospective mortuary-based study of female homicides ages 14 years and older was analyzed. Data were gathered from medical legal laboratory records, autopsy reports, and police interviews from 153 cases at sampled mortuaries in the Western Cape Province of South Africa in 1999. Results: Sixty-two percent of women who were murdered had a high BAC at the time of their death, with an overall median BAC of .11% (110 mg/100 ml). A quantile regression analysis showed that a raised median BAC at the time of death was positively associated with the victim's age; being unemployed or not known to be employed; and being killed in a rural setting, in a public space, and on a weekend. Significant interactions between type of homicide and employment showed a modification in median BACs for unemployed victims killed by intimate partners compared with employed victims, with a median difference of .19% (190 mg/100 ml) (95% confidence interval: .14%-.23% [140-230 mg/100 ml]). Conclusions: This study highlights the public health impact of excessive alcohol consumption and the need for a comprehensive approach to reduce the harmful effects of drinking