AIMS: To evaluate multinational patterns of gender- and age-specific alcohol consumption. DESIGN AND PARTICIPANTS: Large general-population surveys of men's and women's drinking behavior (n's > 900) in 35 countries in 1997-2007 used a standardized questionnaire (25 countries) or measures comparable to those in the standardized questionnaire. MEASUREMENTS: Data from men and women in three age groups (18-34, 35-49, 50-65) showed the prevalence of drinkers, former drinkers, and lifetime abstainers; and the prevalence of high-frequency, high-volume, and heavy episodic drinking among current drinkers. Analyses examined gender ratios for prevalence rates and the direction of changes in prevalence rates across age groups. FINDINGS: Drinking per se and high-volume drinking were consistently more prevalent among men than among women, but lifetime abstention from alcohol was consistently more prevalent among women. Among respondents who had ever been drinkers, women in all age groups were consistently more likely to have stopped drinking than men were. Among drinkers, the prevalence of high-frequency drinking was consistently greatest in the oldest age group, particularly among men. Unexpectedly, the prevalence of drinking per se did not decline consistently with increasing age, and declines in high-volume and heavy episodic drinking with increasing age were more typical in Europe and English-speaking countries. CONCLUSIONS: As expected, men still exceed women in drinking and high-volume drinking, although gender ratios vary. Better explanations are needed for why more women than men quit drinking, and why aging does not consistently reduce drinking and heavy drinking outside Europe and English-speaking countries.