San Francisco has the highest geographic density of alcohol-selling establishments in the State of California. Higher concentration of alcohol-selling establishments in San Francisco neighborhoods is associated with higher levels of alcohol consumption, crime, and nuisance, which in turn, predict poor health outcomes. Although zoning laws and liquor sales regulations are effective means to curtail alcohol retail density and consumption, few studies examine the barriers and facilitators to regulating alcohol density in San Francisco neighborhoods. This study aimed to assess perceptions of the current alcohol-policy landscape in San Francisco and community-led approaches to reform it through a secondary data analysis of focus group data with San Francisco residents in high alcohol-density neighborhoods and spatial mapping data that depict alcohol density in SF neighborhoods.