BACKGROUND: Research on the natural history and long-term outcomes of alcohol use disorders (AUD) is important to guide health policy. However, attrition is a major challenge in longitudinal studies and can affect validity of findings. MATERIALS AND METHODS: A 4-year follow-up study was conducted on a randomly selected subgroup of a sample of men in rural and urban communities in Goa to assess attrition, preliminary estimates of AUD outcomes, and chronic disease risk factors. RESULTS: Overall attrition rate was 16.7% with a higher attrition in AUD compared to abstainers or casual drinkers. Incidence of AUD at 4 years was 12.8% while the persistence rate of AUD was 53.9%. A trend for poorer health and health behaviors and higher blood pressure was observed in AUD. CONCLUSION: The results of this study suggest a relatively low attrition rate despite the long follow-up period and support the feasibility of conducting a definitive cohort study with the entire sample.