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Objectives: To determine the relationship between alcohol-related risk perception and alcohol use in Mexican adolescents and to identify alcohol use prevalence, risk perception level and alcohol use patterns by sex. Materials and methods: Cross-sectional quantitative study with correlational design using a probabilistic sample of 251 teenagers from Nuevo Laredo, Mexico, in 2017. A personal data card, the Alcohol Use Risk Perception Questionnaire and the Alcohol Use Disorders Identification Test (AUDIT) were employed. Results: A higher alcohol-related risk perception level was associated with lower use of this substance (rs = -.235, p <.001). The majority of adolescents used alcohol sometime in their lives (59.0 %) and in the last year (51.8 %). Risk perception and alcohol use patterns were not significantly different by sex. Conclusions: Findings suggest vulnerability to alcohol addiction in the study population. It is advisable to delve, through multidisciplinary research networks, into levels of perception of the risks of drug use to contribute to the production of knowledge that guides preventive actions for teenage men and women. [ABSTRACT FROM AUTHOR]