Abstract: Introduction: There are high rates of co-occurring posttraumatic stress disorder (PTSD) and alcohol use among women Veterans. Given the growing number of midlife women Veterans utilizing Veterans Health Administration (VHA) care and their unique stressors, the purpose of the current study was to examine the unique relationships between PTSD symptom clusters and alcohol use among this group of women. Methods: Fifty treatment-seeking midlife women Veterans (Mage = 50.00; 72% Black/African American) completed self-report measures on demographics, alcohol use and behaviours, and PTSD symptoms as part of their intake at a Veterans Affairs (VA) general mental health clinic. Results: Findings indicated that alcohol use was associated with PTSD symptom severity, as well as the intrusions, negative cognitions and mood, and arousal PTSD symptom clusters, but not the avoidance PTSD symptom cluster, after accounting for branch of service. Discussion: Findings of the current study are in line with previous research highlighting the unique relationship between alcohol use and PTSD symptoms. Our sample was primarily Black/African American midlife women, which may limit the generalizability of our findings. Given high rates of alcohol use and mental health symptoms among women at midlife, providers and researchers alike should aim to better understand the intersection of perimenopause/menopause and mental health outcomes to provide comprehensive health care for at-risk Veterans.