Background: Excessive alcohol consumption by underage students is a serious and persistent problem facing most U.S. colleges and universities. Purpose: This qualitative study explores why underage students engage in high-risk drinking and examines motivational cues that may serve as behavioral deterrents. Methods: Focus groups were conducted with college students under the age of 21 years (N = 59) attending a large university in the southeast. All participants reported consuming five or more drinks in one sitting within the last two weeks (four or more for a female). Results: Participants attach positive expectancies to alcohol use, including peer influence/support and reduction of social anxiety. Negative social consequences such as embarrassment and relationship issues, including perceived sexual opportunities, were cited as disincentives for excessive drinking. Gender distinctions were present among the referenced costs and benefits of excessive alcohol consumption. Discussion: Overall, the negative consequences associated with excess drinking by underage college students are outweighed by positive expectancies such as social approval and acceptance by their peers. Translation to Health Education Practice: Understanding the language, motives and expectancies young people attach to alcohol use can enhance the efficacy of health education and prevention efforts. (Contains 2 tables.)