Objective: To determine predictors of alcohol responsiveness in a large cohort of dystonia patients. Methods: 2159 participants with dystonia were prospectively enrolled in the cross-sectional Dystonia Coalition multicenter study. Patients with secondary, combined or confirmed genetic dystonia (total n=164) or unknown alcohol responsiveness (n= 737) were excluded. Patients answered a standardized questionnaire and were clinically examined using a standardized video protocol and the Burke-Fahn-Marsden Dystonia Rating Scale. Alcohol responsiveness was determined by patients’ self-report. Results: 1258 patients with isolated dystonia (mean age: 59.5±12.2 years, female n=898) met the inclusion criteria; 369 patients (29.3%) reported improvement of dystonia after alcohol consumption. Alcohol responsiveness was not related to sex (p = .742), age (p = .715) or severity of dystonia (p = .623). Age at onset was lower in patients who responded to alcohol (p < .001). Alcohol responsiveness differed across dystonia subgroups (multifocal/generalized > segmental (p = .014); cervical and laryngeal > cranial and limb (p < .001)) and was related to a positive family history of movement disorders (p = .001), and presence of tremor (p < .001). Conclusion: The association of alcohol responsiveness with a positive family history for movement disorders, generalized dystonia, and an earlier age at onset suggests that dystonia patients with an underlying genetic contribution may be more likely to respond beneficially to alcohol. The fact that dystonic tremor may respond to alcohol is in keeping with the observation that the intake of GABAergic drugs may have a beneficial effect in a proportion of patients.