Around a third of trauma incidents such as falls or car crashes involved alcohol consumption, new figures reveal.
Alcohol played some role in 37% of around 5000 incidents over the past year, which also includes assaults and accidental injuries.
The data also suggests that the more severe a trauma was, the more likely it was that alcohol was involved.
NHS Scotland’s information services division said the statistic is "alarming".
It is the first time alcohol has been recorded in this way, in relation to trauma injuries.
Scottish Conservative health spokesman and deputy party leader Jackson Carlaw said: "This is an astonishing figure which lays bare the true extent of Scotland's darker relationship with alcohol. It tells us that almost 40% of acute admissions are avoidable and that too many of them are rooted in excessive alcohol consumption.
"The strong representations of A&E consultants and nursing staff were a key factor leading to Scottish Conservative support for alcohol minimum pricing, the principal benefit of which is expected to be a drop in acute admissions as a result of excessive alcohol consumption.
"However, these figures confirm the urgent need to look beyond alcohol minimum pricing. We have to accept that we have barely scratched the surface of the challenge faced.
"The cost of this to our NHS is huge and, given that it should be avoidable and that many other health challenges require to be faced, it is a cost we can no longer afford."
The report stated: "Information was collected for the first time in 2011 as to whether alcohol had been associated with the trauma. Results show that the likelihood of the involvement of alcohol rises in line with the severity of trauma sustained.
"The fact that alcohol was associated with almost 40% of major trauma is an alarming statistic."
Health secretary Nicola Sturgeon said: "Trauma care in Scotland is of a very high standard and this report shows that there has been an improvement in overall survival of trauma patients since the last audit period in 2002.
"However, the report also shows the increasing involvement of alcohol in severe traumas, with alcohol associated with almost 40% of incidents. This is far too high but the latest in a long line of statistics that show why we are so committed to tackling Scotland's poor relationship with alcohol.
"That is why we have introduced the minimum unit price. Alongside this, our alcohol framework outlines over 40 measures to reduce alcohol-related harm by helping prevent problems in the first place and by improving support and treatment for those who are already experiencing problems."