By better understanding differences in health-risk behaviors among youth in rural, suburban and urban communities, health educators and other public health practitioners can more appropriately focus prevention and health care programs. In this study, we examined data from the national Youth Risk Behavior Survey (YRBS) to determine whether alcohol-related risk behaviors among students are associated with population density. We found that in 2003, only driving after drinking alcohol varied by population density; that is, students in urban communities were significantly less likely to report this behavior than students in rural communities. Temporal trend analyses of 1993-2003 national YRBS data suggested varied patterns in alcohol-related risk behaviors among students attending urban, suburban and rural schools. Given that alcohol-related risk behaviors are high overall, these findings suggest the need to examine school and community policies and programs designed to discourage such behaviors in all population density categories. (Contains 3 tables.)