Data on alcohol consumption, attitudes to and knowledge of alcohol were collected by means of questionnaires from 1133 high school students aged 11–22 years in Lesotho. Additional data were obtained by means of classroom discussion and 13 in-depth interviews. About half of the students (54% of the boys and 42% of the girls) had drunk alcohol at some point in their lives. Drinking was found to be related to age, sex, drinking of friends, family income, and drinking in the family. No indication of widespread alcohol abuse was found, but about half of the students (drinkers and non-drinkers) believed that moderate drinking is impossible and that the fun of drinking is to get drunk, indicating the possibility of alcohol abuse in the future. The results have implications for future research and for preventive work among youth and adults in Lesotho.