Objectives: The following analysis covers the role of the occupational structure in the prevalence of alcohol use disorders (AUDs). The authors investigated whether the occupational position affected the prevalence of AUDs among men and women, and how this relationship varied in lifetime and past year periods. Material and Methods: Data were taken from the General Population Survey on Mental Health in Poland (EZOP) utilizing the Composite International Diagnostic Interview questionnaire (N = 2806). Binary and multiple regression models were employed to assess the risk of AUDs adjusted for the occupational structure and socio-demographic variables. Results: The occupational position affects the prevalence of AUDs in men, while it has no impact on AUDs in women. Skilled and non-skilled workers suffer from AUDs to a greater extent than those in higher occupational positions. However, the risk of alcohol harm in women seems to be equally distributed across the occupational structure. Conclusions: The uneven pattern of alcohol harm in men and women can be possibly explained by shifting working conditions and work environments, as well as traditional gender roles affecting alcohol behaviors. The findings of the study support further development of the occupational position concept in alcohol research. The problem of harmful alcohol drinking in women across the occupational structure warrants a more in-depth inquiry. Int J Occup Med Environ Health. 2021;34(5):591–602