Individual and racial differences in alcohol metabolism and their implications in acute and chronic intoxication of alcohol intake were reviewed in the relationships of genetic polymorphism of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). The recent studies revealed that the catalytic deficiency of ALDH2 isozyme is responsible to the flushing symptom as well as other vasomotor symptoms caused by a higher acetaldehyde level after alcohol consumption. Subsequently the deficiency of ALDH2 has been prevalently found among only the peoples of Mongoloid origin and the individuals deficient in ALDH2 refrain from excessive drinking of alcohol due to averse reaction leading to protection against alcoholism. Moreover, many studies based on DNA analysis have confirmed these findings. As ALDH2 polymorphism was found only in Mongoloid, population studies on the ALDH2 mutant will provide the important information to estimate the dispersal of the ethnic groups in Asia and Oceania and also to prevent alcohol abuse in the developing countries.