Chronic alcohol consumption renders the lung more susceptible to infections, in large part, by disrupting essential alveolar macrophage functions. Emerging evidence suggests that these functional deficits could be due to a suppression of GM-CSF signaling, which is believed to compromise monocyte growth and maturation in the lung. However, in addition to controlling monocyte behaviors, GM-CSF is also important for regulating surfactant homeostasis in the lung. For example, mice with targeted deletion of the gene for GM-CSF accumulate large amounts of phospholipids in their lung. Moreover, decreased GM-CSF signaling in humans has been mechanistically linked to the development of pulmonary alveolar proteinosis (PAP), a rare disorder in which surfactant lipids and proteins accumulate in alveolar macrophages and the lung exhibits enhanced susceptibility to respiratory infections. Consistent with parallel mechanisms in the PAP and alcoholic lung, we recently reported that levels of intrapulmonary lipids, albeit triglycerides and free fatty acids, were markedly increased in BAL fluid, whole lung digests and alveolar macrophages of chronically alcohol exposed rats. Additionally, we showed that uptake of saturated fatty acids alone was capable of inducing phenotypic and functional changes in alveolar macrophages that mimicked those in the alcohol-exposed rat and human lung. Herein, we discuss the role of GM-CSF in surfactant homeostasis and highlight the evidence that links decreased GM-CSF signaling to alveolar macrophage dysfunction in both the PAP and alcohol-exposed lung. Moreover, we propose a mechanism by which lipid accumulation itself can contribute to altering alveolar macrophage behaviors and propose how targeting this mechanism could potentially reduce the susceptibility to pulmonary infections in alcoholics.