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Alcohol prevention in municipalities is an important and complex aspect of drug prevention in Germany. Based on the principle of subsidiarity, prevention measures are characterised by different legal requirements and prevailing conditions. On the one hand, the federal government set a legal framework with the law of prevention (PrävG) in 2015 and established the national strategy of drug policy and prevention in 2012. On the other hand, municipalities are responsible for the detailed design of local drug policy and interventions together with federal states. Furthermore, preventive measures need to fit local challenges and conditions. Hence, we discuss different strategies of alcohol prevention in municipalities and explain how these strategies fit in administrative frameworks. We also look critically at specific local situations and challenges but also at conditions and possibilities to establish a quality-assured local alcohol policy. Promising approaches from pilot projects are contributed to the discussion. Political decisionmakers, scientists and skilled workers accord that alcohol prevention needs to be implemented in municipal settings and that it is a field of growing importance. We conclude that there is a need to improve local prevention measures by creating better access to qualification programs for skilled workers in combination with a constant transfer between science and pratice of current research results and best practices by providing consultation and support from coordinating institutions for local interventions, especially for the identification of challenges and conditions. Local initiatives should receive better access to interventions that are proven to be effective, and these interventions should be sustainable anchored and evaluated in their municipal settings.