Alcohol related injuries and intoxications are common and a burden to society. For policy makers it is important to have insight in the scope of the problem. In the Netherlands the Dutch Injury Surveillance System (DISS) monitors accidents and injuries. DISS is the most advanced specification of the European Injury Database (IDB). At 14 Emergency Departments in the Netherlands all patients with injuries are registered. At this moment an injury is only coded as ‘an injury involving alcohol’ if the use of alcohol is obvious or medically relevant. This leads to an underestimation of accidents involving alcohol. Intoxications, defined as ‘effects of alcohol use being the main cause of the ED visit’, however, are mostly registered correctly. According to DISS in 2016 roughly 5.600 people were treated at an ED for an alcohol intoxication; 16.300 injuries involved alcohol use. The objective of this study was to improve the registration of alcohol related injuries at EDs. Therefore different methods were implemented. Firstly, we asked professional physicians associations to collaborate with us get the new registration method implemented. After several focus group discussions, registration of the doctors own clinical judgement appeared to be a better alternative than to ask every patient if alcohol played a role in the accident. This means that doctors have to answer the question: ‘Is this visit to the ED (also) caused by the use of alcohol?’ Secondly, data collection of this variable will be facilitated within the hospital information system. Results and trends will be available by the end of 2018.