Casinos have been introduced throughout the U.S. to spur economic development and generate tax revenues. Yet, casinos may also be associated with a variety of social ills. One issue that has not been empirically tested in the literature is whether there is a link between casino expansion and alcohol-related fatal traffic accidents. We suspect a link may exist since casinos often serve alcohol to their patrons and, by their dispersed nature, could impact driving distances after drinking. Using the variation in the timing and location of casino openings over a 10-year period, we isolate the impact of casino introduction on alcohol-related fatal accidents. Results indicate that there is a strong link between the presence of a casino in a county and the number of alcohol-related fatal traffic accidents. However, this relationship is negatively related to the local-area (county) population. Results prove durable, as we subject them to robustness checks.