Morbidity and mortality following traumatic injury and hemorrhagic shock is exacerbated in the alcohol-intoxicated individual. The level of hypotension at the time of admittance into the emergency department is a critical indicator of outcome from injury. Previously we have demonstrated that acute alcohol intoxication (AAI) decreases basal mean arterial blood pressure (MABP), exaggerates hypotension throughout hemorrhagic shock (HS), and attenuates the pressor response to fluid resuscitation (FR) in male rodents. This AAI-induced impaired hemodynamic counter-regulation to blood loss is associated with dampened neuroendocrine activation [i.e., epinephrine (EPI), norepinephrine (NE), and arginine vasopressin (AVP) release]. We hypothesize that the blunted neuroendocrine response is the principal mechanism involved in hemodynamic instability during and following HS in AAI. The present study investigates whether enhancing central cholinergic activity via intracerebroventricular (ICV) choline, a precursor of acetylcholine, would restore the neuroendocrine response, and as a result, improve hemodynamic compensation following HS. Chronically-catheterized, conscious, male Sprague-Dawley rats (225–250g) received a primed 15-h alcohol infusion (30% w/v; total ~8g/kg) prior to ICV choline (150μg) injection and were subsequently subjected to fixed-volume HS (50%) and FR with lactated Ringers (2× volume removed). There were a total of eight experimental groups (n=5–12 rats per group): alcohol-treated not hemorrhaged (alcohol/sham), dextrose-treated not hemorrhaged (dextrose/sham), alcohol-treated hemorrhaged (alcohol/hemorrhage), and dextrose-treated hemorrhaged (dextrose/hemorrhage), with ICV choline or water injection. ICV choline immediately increased basal MABP in both control (16%) and AAI animals (12%), but did not alter MABP following HS in either group. ICV choline increased basal plasma EPI (196%), NE (96%), and AVP (145%), and enhanced the HS-induced rise in EPI and AVP, without altering NE responses to HS, in control animals. AAI blunted choline-induced neuroendocrine activation and prevented the HS-induced rise in NE, without affecting post-HS EPI and AVP levels. ICV choline administration to AAI animals enhanced the HS-induced rise in EPI without affecting post-HS NE or AVP. These results indicate that ICV choline produced immediate neuroendocrine activation and elevation in MABP that was not sustained sufficiently to improve hemodynamic counter-regulation in alcohol-treated animals.