Binge drinking is associated with risky behaviours and long-term addiction. Among adolescents, binge drinking should be prevented to avoid these and other hazardous consequences. Adolescent behaviours are known to be influenced by their household and family structures. However, the association between family structure and binge drinking in developing countries remains unknown. The purpose of this study is to examine the role of various family structures and sociodemographic factors on binge drinking among adolescents in South Africa. This cross-sectional study uses data from the South African National Income Dynamics Study (NIDS) Wave 4 (2014/15). The study includes adolescent (15–19 years old) males and females. A total of 79,638 (35.8%) adolescents reported binge drinking. The results show that among the adolescents who binge drink, 60\% are males and 40% are females. Binge drinking increases with age of the adolescents and 62% of adolescents in multigenerational households (parent(s) and grandparent(s)) binge drink. The odds of binge drinking are higher among those living with their grandparent(s) and parent(s) [OR: 1.30, p-value < 0.05], females [OR: 2.06, p-value < 0.05], those in the ‘average’ household income bracket [OR: 2.00, p-value < 0.05] among others. In conclusion, family structure and other socio-demographic factors are associated with binge drinking among adolescents. These results could be used to inform family-orientated programmes which address binge drinking by addressing several generations of family members.