In recent years, the immigrant population has substantially increased in Spain. However, there is a lack of information in the knowledge of alcohol abuse among Spanish immigrants. We describe the epidemiology of alcohol abuse among foreign-born immigrants versus Spanish natives. We carried out a cross-sectional study that uses data from the European Survey of Health on the General Population of Spain of 2009. A sample of 22,188 subjects was analyzed (of whom, 3,162 were foreign). Proxies of problematic alcohol consumption were the prevalence of excessive average consumption and the prevalence of excessive episodic consumption (binge drinking). Descriptive analysis of the population, determination of area of origin with major alcohol consumption and related factors for each kind of consumption, separating immigrant and native population, were performed. The immigrant profile was heterogeneous, though predominantly aged between 35 and 54, and were living with their family and working. 3.4% of immigrants and 3.2% of natives were considered excessive drinkers; 8.9% and 10%, respectively, reported binge drinking in the last year. Immigrants from Northern and Western Europe, and Latin America, Andean countries had significantly a higher report of frequent alcohol consumption and/or binge drinking compared to native. On the contrary, born in Africa was a protective factor. Unemployment was the most relevant related factor, being more important in the immigrant population. The excessive alcohol consumption in immigrants is dissimilar; the interventions must be adapted to their social situation, environments and areas of origin.