The incidence of vascular complications due to drug abuse is at present 
increasing due to new types of drugs and to the different ways of intake of such 
substances. The vascular complications related to drug abuse may affect venous, 
arterious and lymphatic districts and in particular: ischemia following 
intra-arterial injections, arterious and venous pseudoaneurysm, vasculitis, 
aneurysms, aortic dissections, abscesses complicated by erosions of vessels, 
arteriovenous fistulas, compartment syndrome, superficial and deep venous 
thrombosis, septic trombophlebitis, puffy hand syndrome. The scientific 
knowledge in this matter is incomplete because of the new pathological cases and 
the lack of information regarding the efficacy of different treatments. The 
authors report four patients affected by vascular pathologies due to drug abuse. 
In one case, a heroin addict has undergone multiple fasciotomies for 
compartimental syndrome arising because the patient maintained an innatural 
posture for several hours during an overdose coma. In a second case, a segmental 
right subclavear deep venous thrombosis has been treated by pharmacological 
therapy with satisfactory functional recovery of the arm. A third patient has 
been successfully submitted to intra-arterial pharmacological vasodilatation for 
generalised lower limbs vasospasm caused by drug abuse. In the last case, the 
voluntary swallowing of a great dose of cocaine caused the patient's death after 
multiple ischemic and hemorrhagic cerebral episodes. After the description of 
these cases, a review of the recent literature and some observations on this 
topic are presented. A better knowledge of vascular complications due to drug 
abuse should improve the therapeutical approach of these patients.