Antimicrobial compositions are provided that include a hydroalcoholic solvent system comprising a lower C2-C5 alcohol and water; a cationic antimicrobial agent such as chlorhexidine gluconate; a fatty component containing at least one free hydroxyl group, such as a C12-C21 fatty alcohol, a C12-C21 fatty ester, a C12-C21 fatty ether, a C12-C21 fatty amide, and combinations thereof; and optionally an emollient ester such as diesters of bibasic acids and trimesters of citric acid. The compositions described herein display improved antimicrobial efficacy and improved cosmetic elegance. Methods of using the antimicrobial compositions are provided.