The purpose of this narrative review is to highlight the recent human neuroimaging literature on SG differences in brain function and structure as it pertains to alcohol use across multiple imaging modalities from the last 10 years. We include SG effects from PET, MRI, and fMRI studies examining the neural effects of acute alcohol ingestion, AUD, and in those at risk for AUD. Additional work using magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and event-related potentials (ERPs) to examine SG differences in AUD will also be briefly covered. We aim to highlight the state of the alcohol imaging field as it pertains to the inclusion of SABV, identify gaps in our knowledge, and provide future considerations for investigating SG differences in the neural mechanisms underlying AUD.