Aim To identify differences in Risky Consumption (RC) and Binge drinking (BD) trends in students who already followed these patterns of alcohol consumption on starting university and those who did not, and also to try to understand what leads students to engage in these types of behaviour at university. Material and methods Cohort study among university students in Spain (n = 1382). BD and RC were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27 years. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). Results The prevalence rates of RC and BD were lower throughout the study in students who did not follow these patterns of consumption at age 18. For RC and BD, the differences at age 27 years, expressed as percentage points (pp), were respectively 24 pp and 15 pp in women and 29 pp and 25 pp in men. Early age of onset of alcohol use increased the risk of engaging in RC and BD patterns at university, for men (OR = 2.91 & 2.80) and women (OR = 8.14 & 5.53). The same was observed in students living away from the parental home for BD (OR = 3.43 for men & 1.77 for women). Only women were influenced by having positive expectancies for engaging in RC (OR = 1.82) and BD (OR = 1.96). Conclusions The prevalence rates of both RC and BD at age 27 years were much higher among university students who already followed these patterns of consumption at age 18 years, with the differences being proportionally higher among women. Focusing on the age of onset of alcohol consumption and hindering access to alcohol by minors should be priority objectives aimed at preventing students from engaging in these patterns of alcohol consumption at university This work was supported by grants awarded by the Plan Nacional sobre Drogas (Spain) (2005/PN014) and the Fondo de InvestigacioÂn Sanitaria (Spain) (PI15/00165). Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministry of Education. Eduardo LoÂpez-Caneda was supported by the SFRH/BPD/109750/2015 Postdoctoral Fellowship of the Portuguese Foundation for Science and Technology SI