The per capita alcohol consumption of the Northern Territory, Australia, is second highest in the world, estimated 15.1 liters of pure alcohol per year. Alcohol abuse is a major public health concern among Aboriginal and Torres Strait Islander people in Australia. The Aboriginal and Torres Strait Islanders in the Northern Territory consume approximately 16.9 liters of pure alcohol per year. This descriptive review is based on current published and grey literature in the context of high risk alcohol use, with a special focus on the epidemiological, etiological, and social factors, to predict alcohol misuse among the Australian Aboriginal and Torres Strait Islanders in Northern Territory. The methodology involved a descriptive search on PubMed, Northern Territory government reports, health databases, and Web sites with an emphasis on the etiology and epidemiology of high-risk alcohol consumption among the Australian Aboriginal and Torres Strait Islanders of the Northern Territory. This review has its own limitations because it does not rely on systematic review methodologies. However, it presents real data on the motives for binge drinking and alcohol-related violent assaults of this vulnerable population. Alcohol abuse and alcohol-related harms are considerably high among the rural and remote communities where additional research is needed. High-risk alcohol misuse within Australian Aboriginal and Torres Strait Islanders communities often leads to a series of physical and social consequences. This review highlights the need for culturally appropriate intervention approaches focusing on alcohol misuse among the Aboriginal and Torres Strait Islanders population of the Northern Territory.