This paper explores the role of metacognitions in alcohol abusers, specifically metacognitive experiences and strategies that occur when alcohol abusers have intrusive thoughts or memories about alcohol. In Study 1, 87 participants with a diagnosis of alcohol dependence were examined with a preliminary inventory of metacognitions that was then factor analyzed and revised. In Study 2, 144 alcohol patients completed the Metacognition Questionnaire for Alcohol Abusers (MCQ-A). The purpose of the study was to cross-validate the factor structure and test the reliability and construct validity of the questionnaire. Analyses of the MCQ-A identified two broad, replicable factors, which were named Uncontrollability and Thought-Action Fusion (Factor 1) and Unpleasantness (Factor 2). A third factor was called Subjective Utility of the Thought. The first two factors were associated with measures of craving, thought suppression, and drug-taking confidence. The results indicate that metacognitions about alcohol can be reliably identified, and they are clearly related to therapeutically relevant variables.