Major depressive episode (MDE) and alcohol use disorder (AUD) often co-occur and the presence of one doubles the risk for the other, which brings disabling social and health consequences. Increasing evidence supports integrated treatment of co-occurring MDE and AUD, including combined medications for both conditions as well as behavioral therapies. While young adults suffer disproportionately from these co-occurring conditions, little is known about their treatment utilization. Using nationally representative data from the National Survey on Drug Use and Health (NSDUH), 2011–2019, this study examined temporal trends and disparities in the prevalence and treatment use for co-occurring MDE and AUD among young adults aged 18–25 in the U.S. Across the survey time, an increasing trend of MDE was revealed, whereas the prevalence of AUD decreased significantly. Meanwhile, the prevalence of co-occurring MDE and AUD remained steady. Among young adults with co-occurring MDE and AUD, while treatment use for MDE increased from 2011 to 2019, treatment use for AUD and co-occurring conditions remained stable. Observed widening disparities in co-occurring treatments utilized among young adults ages 18–25 are further perpetuated by gender, emerging adulthood, and socioeconomic status, warranting immediate action. (PsycInfo Database Record (c) 2022 APA, all rights reserved)