Adult (18+ years old) Malawian men and women’s alcohol use and social drinking norms were examined. From 31,676 screened households, heads and spouses in 1,795 households with at least one alcohol user were interviewed. Alcohol use last 12 months was reported by 27.3% and 1.6% of all adult men and women respectively. Male and female alcohol users’ mean consumption was 8.05 liters and 1.51 liters 100% alcohol respectively. Spouses reported 55 and 61% higher consumption level for their spouses compared to self-reports. Without including non-drinkers, drinking norms explained 6.7% of men’s and 20.9% of women’s alcohol consumption. Prevention effort could be to help women not to start drinking by supporting (their existing) gender-specific descriptive drinking norms.