Transit operators, relative to workers in many other occupations, experience high levels of work-related stress, as documented through neuroendocrine elevations on the job vis-à-vis resting states (J Occup Health Psychol. 1998;3:122–129). Previous research suggests that self-reported job stress is associated with higher levels of alcohol consumption among transit operators (Alcohol Clin Exp Res. 2000;24:1011–1019) and with absenteeism (Working Environment for Local Public Transport Personnel, Stockholm: Swedish Work Environmental Fund, 1982; Work Stress. 1990;4:83–89). The purpose of this study was to examine the interrelationships between alcohol use, stress-related factors (stressful life events, job stressors, and burnout), and short-term absenteeism among a multiethnic cohort of urban transit operators. Self-reported measures of alcohol, stress-related factors, and short-term absenteeism were obtained from a sample (n = 1,446) of San Francisco municipal transit operators who participated in the 1993–1995 Municipal Railway Health and Safety Study. Multivariate logistic regression analyses showed that absenteeism among drinkers was associated with risk for alcohol dependence [odds ratio (OR) = 2.46, heavy drinking (OR = 1.87), alcohol- related harm (OR = 2.17), increased drinking since becoming a transit operator (OR = 1.74), and having any problem drinking indicator (OR = 1.72). The association between absenteeism and stress-related factors varied by gender and drinking status. Final multivariate models among drinkers indicated that among males, problem drinking (OR = 1.82), stressful life events (OR = 1.62), and job burnout (OR = 1.22) were independently associated with elevated odds of absenteeism. Among female drinkers, only stressful life events (OR=5.17) was significantly associated with elevated odds of absenteeism. Findings suggest that workplace interventions that address both individual and environmental stressors are most likely to have a positive impact on health-related outcomes, including problem drinking, thereby reducing absenteeism.