Background. Understanding the role of the family in shaping adolescent substance use behaviours has been given recently the increased attention in context of high level of alcohol consumption in the country. The study was aiming to investigate association between alcohol use and a range of familial factors in Lithuanian adolescents. Methods. The questionnaire survey was carried out among adolescents (N = 3696) aged 13- and 15-years in Lithuania in spring 2014 in the framework of the cross-national Health Behaviour in School-aged Children (HBSC) study. A standard HBSC questionnaire was applied and used anonymously to obtain information about drinking of alcoholic beverages and family life (family structure, communication in the family, parental monitoring, parenting style, etc.). Logistic regression analysis was used to assess association between variables. Results. Respondents from non-intact families were more likely to be weekly drinkers (OR = 2.13, 95% CI = 1.78-2.54) and more likely to be exposed to drunkenness (OR = 1.51, 95% CI = 1.29-1.77) compared with intact families. Among adolescents living in an intact family the following familial factors were significantly related with increased risk for regular use of alcohol or frequent drunkenness: father’s and mother’s low monitoring (OR = 1.73, 95% CI = 1.25-2.39; OR = 2.34, 95% CI = 1.70-3.21), father’s authoritarian-repressive (OR = 2.48, 95% CI = 1.43-4.29 and mother’s permissive-neglectful (OR = 5.11, 95% CI = 2.94-8.87) parenting style. Therefore, rare family time together and rare electronic media communication with parents showed an opposite effect than the research hypothesis. Conclusions. Higher prevalence of alcohol use among adolescents of Lithuania is associated with a non-intact family structure as well as weaker parental support. Positive family life practices (parental monitoring and parental support) are critical components to be incorporated in the alcohol use prevention programs for adolescents in Lithuania.