Objective-This study examines the magnitude of association between alcohol misuse with recent depressive symptoms.Methods-A cross-sectional study of 412 randomly selected patients ≥18 seeking ED care.Results-51.0% reported depressive symptoms. At-risk drinking was reported by 26.0% of the sample, 28.2% scored positive for RAPS4. Alcohol abuse, and Binge drinking were reported by 25.1% and 28% of the patients, respectively. According to our results at-risk drinking (OR 2.49; CI 1.47-4.20; P ≤ .001), problem drinking (OR 2.11; CI 1.27-3.51; P ≤ .004), drinking abuse (OR 2.58; CI 1.51-4.40; P < .001), and binge drinking (OR 1.89; CI 1.13-3.15; P < .001) were all related to manifestation of depression symptoms.Conclusion-The findings of this study yield information that could be used by emergency department health care practitioners and health educators to educate ED patients at-risk for alcohol misuse and depression.