Heavy Episodic Drinking (HED) is becoming a common drinking pattern among young adults in South Europe. Additionally, alcohol consumption has increased among young women, narrowing the gender gap in alcohol use. In the scope of the European action-research project 'ALLCOOL', this study explores sex-related differences on HED among young adults [18-29] living in Southern European cities of Porto, Tarragona and Bologna. A total of 1141 participants completed a self-administered questionnaire that measured drinking patterns, protective behavioural strategies and alcohol-related negative consequences. Data analysis revealed significative sex-related differences: men present higher levels of HED and suffer more negative consequences; while women use more protective behavioural strategies. These differences can be explained in terms of gender roles that invite men to excess and women to self-control. These results might inform gender-sensitive community interventions and policies addressing HED.