Purpose: Most research on risky drinking among adults in Korea has focused on problem drinking and high-risk drinking. This paper examines the nature of heavy episodic drinking_(HED) among adults and seeks to identify the risk factors for HED by analyzing differences by gender and age. Method: Participants were 3,886 adults aged 19-64 years from the database of the fifth Korean National Health and Nutritional Examination Survey (KNHANES-V, 2010). Data were analyzed by conducting the Rao_Scott chi-square test, an ANCOVA, and logistic analysis with SAS 9.2. Results: Individuals between 19 and 29 years of age had the highest HED among all age groups. Individuals between 40 and 49 (male adults) and those between 30 and 39 (female adults) showed HED associated with stress, suicidal ideation, smoking, and other health behavior-related variables. Risk factors that affected HED in male adults were age, educational status, and current smoking, while for female adults, the factors were age, educational status, employment, marital status, and current smoking. Conclusions: It is necessary to develop appropriate intervention programs that abate negative emotions and lessen the risk of HED in adults with consideration to gender and age differences.