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The commercial alcohol industry in Africa may provide opportunities to increase market access and incomes for smallholder farmers by increasing access to agriculture-alcohol value chains. Despite the benefits of increased market opportunities, the high costs to human health and social welfare from increased alcohol use and alcoholism could contribute to a net loss for society. To better understand the tradeoffs between increased market access for smallholders and societal costs associated with harmful alcohol consumption, this paper provides an inventory of the societal costs of alcohol in Sub-Saharan Africa (SSA). We examine direct costs associated with addressing harmful effects of alcohol and treating alcohol-related illnesses, as well as indirect costs associated with the goods and services that are not delivered as a consequence of drinking and its impact on personal productivity. We identified resources using Google Scholar and the University of Washington libraries, and utilized the Global Burden of Disease (GBD) database by the Institute for Health Metrics and Evaluation (IHME) and the World Health Organization’s Global Information System on Alcohol and Health (GISAH) database. We also utilized FAOSTAT to retrieve raw data on national-level alcohol production and export statistics. We find that hazardous alcohol use contributes to early mortality and morbidity, loss of productivity, property damage, and other social costs and harms for drinkers and those around them. Drinking also affects vulnerable segments of the population disproportionately. Policymakers, local authorities, and donor agencies can use the information presented in this paper to plan and prepare for the higher consumption levels and subsequent social costs that may follow through agricultural development and economic growth in the region.