Methamphetamine is a substance of abuse that is most commonly smoked. Both regular and non-regular use can cause toxic injury to the lung parenchyma, the signs and symptoms of which are non-specific. Clinical scenarios include non-cardiac pulmonary oedema, acute respiratory distress syndrome, alveolar haemorrhage, pneumonia and pneumoconiosis. As radiological imaging is often non-specific, a positive history of methamphetamine use is the only way to reach a definite diagnosis. The use of methamphetamine is now increasing in Europe, so it is important as physicians to be aware of this differential diagnosis in patients in respiratory distress with risk factors for illicit drug use.A case of methamphetamine-induced lung injury with non-specific findings is described.In those presenting with respiratory symptoms and no obvious cause identified, consideration must be given to a diagnosis of drug-induced lung injury.Treatment for methamphetamine-induced lung injury is supportive, for example with oxygen supplementation, and symptoms should resolve after cessation of use; there is no evidence that steroids are of benefit.