Drinking environments, including bars, nightclubs and their surrounds are associated with high levels of acute alcohol-related harms. This systematic review examined the effectiveness of interventions implemented in drinking environments to reduce alcohol use and associated harms. The findings of the review were limited by the methodological shortcomings of the included studies. However, three studies indicated that multicomponent programmes combining community mobilisation, RBS training, house policies and stricter enforcement of licensing laws may be effective in reducing assaults, traffic crashes, and underage sales depending on the focus of the intervention. The effectiveness of other intervention approaches was limited. Future studies of interventions in drinking environments should focus on using appropriate and robust study designs.