Intimate partner violence (IPV) is prevalent among samples with diagnosed alcohol use disorders (AUDs), but few studies have evaluated the factors that account for this increased risk, and none have systematically evaluated the risk posed by comorbid physical health conditions. The present study evaluated the likelihood of perpetrating IPV among alcohol diagnosed offenders with medical health problems relative to healthy counterparts. Physical health and partner violence data provided by 655 criminal offenders with AUDs diagnosed during a court-ordered substance abuse evaluation were examined. One third of participants (35.3%) endorsed a physical health condition, and 46.4% reported perpetrating physical IPV. The odds of perpetrating IPV among participants with a physical health condition were 2.29 times larger than among healthy participants. Specific conditions emerged as risk factors for IPV, including brain injury, cardiac issues, chronic pain, liver issues, gastrointestinal symptoms, hepatitis, and recent injury. Findings highlight the importance of identifying and managing physical health conditions that may complicate IPV treatment efforts. Integrated behavioral and medical health treatment approaches may increase treatment compliance and reduce the risk of future partner violence among offenders with co-occurring issues, such as mental illness, addiction, and physical health conditions.