Heart rate has been a widely used measure in experimental investigations of alcohol and stress. Meaningful interpretations from this measure, however, may be threatened due to methodological problems. This article critically reviews alcohol administration studies that have utilized heart rate as an index of stress response. Potential confounds stemming from the use of heart rate are identified and suggestions for its future use are presented. Implications for high-risk studies are discussed. It is concluded that (a) the amount of time provided for the absorption of an alcohol or placebo beverage is highly correlated with postdrink heart rate change, (b) the magnitude of this postdrink heart rate change is highly associated with the probability of finding a subsequent stress response dampening effect, and (c) offspring of alcoholics appear to manifest a heightened heart rate response to alcohol, which may account for apparent enhanced stress response dampening effects among these subjects.