OBJECTIVE: The purpose of this study was to evaluate levels of post-traumatic stress disorder (PTSD), depression, alcohol abuse, quality of life, and mental health service utilization among returnees from Operation Enduring Freedom and Operation Iraqi Freedom. METHODS: One hundred twenty returnees, enrolled for health care at a midwestern Veterans Affairs medical center, completed questionnaires approximately 6 months after their return from deployment. RESULTS: PTSD levels (12%) were consistent with previous research while problematic drinking levels were also elevated (33%). PTSD and, to a lesser degree, alcohol abuse were associated with lower quality of life in multiple domains, even when controlling for the influence of depression. Of those screening positive for PTSD, 56% reported using mental health services. Only 18% of those screening positive for alcohol abuse reported using such services. CONCLUSIONS: PTSD and alcohol problems are prevalent in Operation Enduring Freedom/Operation Iraqi Freedom returnees and associated with lower quality of life. Mental health service utilization is limited, even among returnees enrolled for Veterans Affairs health care.