The increasing intranasal abuse of cocaine has been associated with numerous medical problems. Among the most common complications are chronic sinusitis and septal perforation, although myocardial infarction and death also have been reported. We describe the development of Pott's puffy tumor in a patient who chronically abused cocaine. Pott's puffy tumor, a subperiosteal abscess of the frontal bone associated with frontal osteomyelitis, is a rare complication of frontal sinusitis. This case report underscores the dangers of cocaine abuse and describes yet another potentially serious sequela.