The relationship between alcohol misuse, employment and unemployment is complex. Alcohol misuse is correlated with a range of other problems, including, for example, drug misuse, mental health problems and social deprivation. Together these can be a barrier to accessing and sustaining employment. The aim of this study was to explore these issues with a sample of adults in the UK who were currently accessing treatment for an alcohol problem. The study involved a systematic literature review followed by qualitative research with 53 treatment service clients and 12 professionals across 5 research sites in England, Scotland and Wales. The findings focus on the main facilitators and barriers, both individual and organisational, for returning to work identified by interviewees. Some of the facilitators and barriers identified were similar to those described in the literature for other groups of unemployed adults. Others were more specific to alcohol misusers; for example, the stigma experienced by interviewees as a result of the views of others regarding substance misuse, the nature of recovery from addiction and the challenges posed by the prevalence of coexisting mental and physical health problems. Despite the problems faced by many of the study participants, however, the majority were eager to return to work, and this desire to gain employment is discussed in the context of ongoing welfare reform in the UK.