Seven patients with presumed amphetamine-associated stroke are reported. Ischaemic stroke occurred in four patients, a transient ischaemic attack in one patient and a haemorrhagic stroke in two patients. All patients had used amphetamines within hours of the onset of focal neurological symptoms, but drug abuse was not admitted by three patients until 4, 5 and 8 weeks, respectively, after the admission. Other predisposing factors, besides concurrent alcohol abuse (n = 6), were present in only one patient (pro-coagulant state and protein-S deficiency). Amphetamine-associated stroke is heterogeneous clinically, pathologically and aetiologically. Drug abuse should always be considered in young patients with stroke, even if the patient denies the use of recreational drugs and if other stroke risk factors are present.