Alcohol is a well-known central nervous system depressant. Individual reactions to alcohol might vary, but the connection between alcohol consumption and tolerance to loud noise or difficulties in communication in noisy environments are well-observed phenomena; for example, at evening parties. The purpose of this study was to evaluate how acute alcohol intake affects the peripheral to central auditory pathways. Previous studies have documented positive associations between alcohol consumption and increased auditory thresholds (Murata et al 2001; Upile et al 2007). The authors’ novel approach was to assess auditory temporal processing and hearing ability in background noise along with other tests measuring hearing thresholds. A total of 43 healthy patients were recruited following ethical approval from Hallym University (Republic of Korea). They were tested twice (24 hours free of alcohol and 30 mins after alcohol intake). The target blood alcohol content was 0.05% (measured with breathalysers). The test battery was composed of pure-tone audiometry, speech reception threshold (SRT), word recognition score (WRS), distortion product otoacoustic emission (DPOAE), gaps-in-noise (GIN) test, and Korean matrix sentence test (testing speech perception in noise). Results revealed acute alcohol intake elevated pure-tone hearing thresholds and SRT but did not affect WRS. Both otoacoustic emissions recorded with DPOAE and the temporal resolution measured with the GIN test were not influenced by alcohol intake. The hearing performance in a noisy environment in both easy (-2 dB signal-to-noise ratio [SNR]) and difficult (-8 dB SNR) conditions was decreased by alcohol from 91.9% to 84.2% in easy conditions and 53.6% to 44.1% in difficult conditions, respectively. The authors summarise alcohol influenced the auditory processing related to the central auditory pathway rather than the peripheral pathway. Additionally, alcohol affects complex auditory tasks rather than simple tasks.