Abstract: Objective To study the status quo of alcohol drinking behavior and its relationship with acquired immunodeficiency syndrome (AIDS) related factors among the men who have sex with men (MSM). Methods A anonymous questionnaire survey and blood test for human immunodeficiency virus (HIV) and syphilis infection were conducted among 402 MSM recruited with snowball sampling in Mianyang city during September 2012 and March 2013. Results Of the MSM, 44.0% reported alcohol drinking; of the alcohol drinkers during the previous 6 months, 26.0% and 30.5% reported alcohol drinking frequency of ≤1 and 2-3 times per month; 24.3%, 5.1%, and 3.4% reported the frequency of 1-2, 3-4, and 5-6 times per week; and 10.7% reported having alcohol drinking ≥1 time per day.The results of multivariate analysis showed that the independent factors of alcohol drinking included education level (odds ratio OR=0.352, 95% confidence interval 95%CI:0.166-0.747), having unsafe anal sex in the latest homosexual activity (OR=3.351, 95%CI:1.131-9.925), having heterosexual activity during latest 6 months (OR=2.800, 95%CI:1.017-7.706), having anal sex 3 times or more during the latest 6 months (OR=2.339, 95%CI:1.003-5.453), and smoking (OR=0.372, 95%CI:0.175-0.790); there were significant interactions among smoking, alcohol drinking, and unsafe homosexual anal sex (P=0.047). Conclusion Alcohol drinking is prevalent and has impacts, synergistically with smoking, on high risk AIDS-related behaviors among MSM in Mianyang city;the results suggest that intervention on alcohol drinking among MSM is important for the control of AIDS.