Alcoholic beverages are obtained from the fermentation of sugars, with ethanol being their main component. Additionally, other chemical substances are produced depending on the manufacturing processes. The World Health Organization estimated that globally, more than two billion people consume alcoholic beverages. Individuals exposed to ethanol and other substances contained in these beverages may experience adverse reactions that affect their health. Alcoholic beverages have been part of Western culture for thousands of years. Wine and beer were used in celebrations as well as in the treatment of diseases. The Arabs perfected the distillation process, leading to beverages with higher alcohol concentrations. Today, fermented and distilled beverages are consumed worldwide for recreational purposes but are associated with health damage. Ethanol is a substance with a wide volume of distribution in the body. It is primarily metabolized by the enzyme alcohol dehydrogenase into acetaldehyde, a cytotoxic metabolite related to deleterious damage to hepatocytes and intolerance to alcoholic beverages. Allergies to ethanol are rare, but other components of alcoholic beverages, called congeners, can sensitize the immune system and develop immunoglobulin-E-mediated allergic reactions and pseudo-allergic reactions due to histamine. Ethanol intoxication directly affects the central nervous system, mainly causing an imbalance between GABA and glutamate neurotransmitters. Clinically, individuals exhibit sensory-motor alterations and behavioral changes. Other systems affected by excessive ethanol intake include the cardiovascular and gastrointestinal systems. Intolerance, allergies, and intoxication from alcoholic beverages can have fatal consequences if not promptly diagnosed, emphasizing the need for updated toxicology knowledge among healthcare personnel.