Given the public health impact of adolescent alcohol use and heavy episodic drinking, we sought to identify the prevalence of types of alcohol use among national samples of 8th- and 10th grade American students. In addition, a range of known risk factors was used to predict the most problematic type: heavy episodic use. Monitoring the Future data on lifetime, past-year, and past-30-day alcohol use and on past-2-week heavy episodic drinking were available for 505,668 students from 1991 to 2007 (weighted N = 505,853; 51.5% girls; 65.3% White, 12.3% Black, 11.1% Hispanic). Logistic regression was then used in a representative subsample of 110,130 students to predict heavy episodic drinking in the previous 2 weeks. In the most recent cohorts, about 1 in 10 8th graders and 1 in 5 10th graders had engaged in heavy episodic drinking in the past 2 weeks. Explanatory variables in logistic regression were largely invariant across cohort, grade level, gender, and race/ethnicity, accounting for 48% of the variance in heavy episodic drinking. Heavy episodic drinking continues to be a prevalent behavior among the nation's youth, with consistent risk factors over time, highlighting the continued necessity of effective screening and prevention efforts.