Background: Heavy drinking is linked to a number of deleterious consequences, many of which carry the possibility of regret: a negative cognitive emotion involving self-blame. Purpose: The purpose of this study is to determine who among undergraduates is most likely to experience alcohol-related regret. Method: Data were taken from an online survey of undergraduates (N = 354) from a Midwestern university. Results: Though both men and women were more likely to report alcohol-related regret when they engaged in drinking to get drunk, participation in Greek life and intercollegiate sports were significant predictors of alcohol-related regret for women. Discussion: Behavioral intentions matter, and when students drink with the intention of getting drunk, they are more likely to experience situations that can compromise their health and safety and jeopardize the networks that bind them to the university. The strength of reference groups and peer norms may also influence college women's behavioral choices. Translation to Health Education Practice: A harm reduction approach may be best suited to the effective management of student alcohol use. When centered within the social contexts that are most influential to students (eg, sororities/fraternities, sports teams), group programming efforts may have the greatest potential impact.