Three male patients developed a total of four episodes of acute rhabdomyolysis associated with documented cocaine intoxication (two caused “crack” and two caused by intravenous cocaine). Included is one patient who developed rhabdomyolsis after injecting cocaine and then redeveloped it 6 months later on “rechallenge.” One of the four cases resulted in death related to severe hyperkalemia and ischemic bowel. The remaining three episodes followed a course of nonoliguric renal failure.