AbstractCrystal polymorphism in the antitumor drug temozolomide (TMZ), cocrystals of TMZ with 4,4′‐bipyridine‐N,N′‐dioxide (BPNO), and solid‐state stability were studied. Apart from a known X‐ray crystal structure of TMZ (form 1), two new crystalline modifications, forms 2 and 3, were obtained during attempted cocrystallization with carbamazepine and 3‐hydroxypyridine‐N‐oxide. Conformers A and B of the drug molecule are stabilized by intramolecular amide NH⋅⋅⋅Nimidazole and NH⋅⋅⋅Ntetrazine interactions. The stable conformer A is present in forms 1 and 2, whereas both conformers crystallized in form 3. Preparation of polymorphic cocrystals I and II (TMZ⋅BPNO 1:0.5 and 2:1) were optimized by using solution crystallization and grinding methods. The metastable nature of polymorph 2 and cocrystal II is ascribed to unused hydrogen‐bond donors/acceptors in the crystal structure. The intramolecularly bonded amide N–H donor in the less stable structure makes additional intermolecular bonds with the tetrazine CO group and the imidazole N atom in stable polymorph 1 and cocrystal I, respectively. All available hydrogen‐bond donors and acceptors are used to make intermolecular hydrogen bonds in the stable crystalline form. Synthon polymorphism and crystal stability are discussed in terms of hydrogen‐bond reorganization.