While attention to the socio-ecological and political economic influences on health grows, there remains a paucity of political ecological analyses of health (King, 2010). At the same time, the growing burden of non-communicable diseases (NCDs) in the Global South demands new conceptual and pragmatic engagements with their modifiable risk factors. Drawing on the example of SouthAfrica, this paper argues that alcohol consumption might usefully be theorised in political ecological lexicon as a “disaster”. To do so, it draws attention to the upstream causes of vulnerability, rather than just the downstream effects of risky drinking. This reorientation is needed for sustainable, publicly acceptable alcohol policies. To realise this, it draws on Blaikie et al.’s (1994, 2003) political ecological approach to risk, vulnerability and coping and, more specifically, applies their Pressure and Release model to explore liquor as a situated “disaster” in SouthAfrica’s Western Cape province. In so doing, it aims to mark out an under-explored research agenda that considers alcohol as a pervasive governance dilemma. In addition, it also reflects on the model’s utility as a means of communicating findings that might reorient policy discussions on alcohol control in both SouthAfrica and countries of the Global South