Alcohol misuse on college campuses has been shown to be the cause of physical, socio-emotional, and academic harm. Alcohol is also an issue at Gallaudet University, the only liberal arts university for the deaf, but there is a gap in the literature describing the phenomenon in the environment and how to address it. This qualitative case study explored the perceptions and experiences of alcohol use and alcohol-related consequences for deaf and hard of hearing college students through interviews with 50 students and staff at Gallaudet University. Alcohol misuse and related harms were explored through the framework of the social ecological model, focusing on the intrapersonal, interpersonal, and university-levels. For the intrapersonal level, the study showed the following themes: amount of alcohol used, reasons for decisions about alcohol, something to do, young/freshmen, fear of missing out, “come to have fun,” isolation, “numbing out” and coping, and religion. For the interpersonal level for students, the themes were communication, family, school environments, social networking through schools for the deaf, social isolation for mainstream students, social dynamics, belonging, “playing catch up with life,” peer pressure, role of upperclassmen, athletes, role of staff, and protective behavior. For the university-wide factors, the themes were Gallaudet dynamics, tradition, “going hard” culture, education, intervention, and alternative activities. It is hoped that the insights gained from this study will be used to inform interventions for deaf and hard of hearing college students, to reduce alcohol misuse and related harms, and thus to impact positive social change