The 5-year "Preventing Alcohol Trauma: A Community Trial" project in the United States was designed to reduce alcohol-involved injuries and death in three experimental communities. The project consisted of five mutually reinforcing components: (1) Community Mobilization Component to develop community organization and support, (2) Responsible Beverage Service Component to establish standards for servers and owner/managers of on-premise alcohol outlets to reduce their risk of having intoxicated and/or underage customers in bars and restaurants, (3) Drinking and Driving Component to increase local DWI enforcement efficiency and to increase the actual and perceived risk that drinking drivers would be detected, (4) Underage Drinking Component to reduce retail availability of alcohol to minors, and (5) Alcohol Access Component to use local zoning powers and other municipal controls of outlet number and density to reduce the availability of alcohol. This paper gives an overview of the rationale and causal model, the research design and outline of each intervention component for the entire prevention trial.