Underage alcohol use is the leading cause of preventable mortality among adolescents in the USA. Moreover, the average age of onset of underage drinking is 13 years. This study examined the feasibility of using a text messaging survey (TMS) to assess adolescent alcohol use. A sample of 29 adolescents, aged 13-17 years, was recruited from two primary care clinics. They completed a 16 question TMS while in the waiting room and a two-question exit TMS. The participation rate was 87%. Two out of 25 (8%) adolescents met the criteria for hazardous drinking and 28% reported alcohol use. It was found that 38% and 25% of adolescents who completed the exit TMS were asked or advised about drinking, respectively. Text messaging to assess adolescent alcohol use in this setting seems feasible, does not disrupt patient workflow, and can assess many health behaviors before a clinical encounter.