Background: Visually impaired individuals have a higher prevalence of chronic diseases compared with the general Korean population. However, little is known about the associations between alcohol drinking and chronic diseases in this population. This study aimed to examine these associations among severe vision disorders among adult men. Methods: A total of 237 men severely visually impaired adults aged 50 years or older were surveyed. Alcohol use was assessed using the Alcohol Use Disorders Identification Test–Korean version. Logistic regression analyses were performed to identify associations between alcohol drinking behaviors and chronic diseases, adjusting for age, body mass index, education level, economic activity, physical activity, regular diet habits and smoking. Results: Hypertension was the most common condition (22.8%), followed by liver disease (16.6%) and diabetes mellitus (16.2%). Other reported conditions included osteoarthritis (9.0%), pneumonia (8.4%), kidney disease (8.2%), heart disease (5.7%), cerebrovascular disease (5.7%), cancer (4.5%), and gout (3.1%). Only 11.8% of participants reported no chronic conditions, while 22.4% had one and 28.3% had two. Multimorbidity (≥3 conditions) was observed in 37.6% of participants, with 7.2% reporting five or more conditions. Past drinkerson-drinkers showed a significantly lower odds of heart disease (P=0.006) and pneumonia (P=0.011). In contrast, arthritis showed a significantly higher risk among current drinkers (P=0.039). Hazardous drinkers (Alcohol Use Disorders Identification Test–Korean version score≥8) showed a higher prevalence of cancer (P=0.023) and liver disease (P=0.024) compared with non-hazardous drinkers. Hazardous drinking was associated with 9.00-fold increased risk of diabetes (95% confidence interval=1.68–48.14, P<0.05). Conclusions Hazardous drinking showed 9.00-fold increased risk of diabetes among adults with severe visual impairment. Tailored health promotion programs are needed to address alcohol drinking behaviors and prevent chronic diseases in this population.