This study examined the relationships between alexithymia, impulsivity, and alcohol use and related problems. The sample consisted of 429 undergraduate students who reported drinking alcohol at least once in the past 3. months. Negative urgency mediated the relationship between alexithymia and alcohol-related problems, whereas positive urgency mediated the relationship between alexithymia and alcohol consumption. In addition, positive urgency moderated the relationship between alexithymia and alcohol-related problems, increasing the strength of this association. These results indicate distinct relationships between alexithymia and negative urgency and positive urgency in predicting alcohol consumption and related problems. The findings of this research contribute to the body of the literature on alexithymia, self-regulation, and etiology of alcohol misuse and related consequences. Furthermore, the findings of the current study provide support for the importance of emotion identification and expression skills training in substance abuse treatment.