"Ecstasy" (3,4-Methylenedioxymethamphetamine), is used as a mood enhancer. We describe a case of a 23 year-old male suffering from thrombotic thrombocytopenic purpura (TTP), and severe hepatitis following ingestion of ecstasy. We describe the various hepatic complications, including hepatitis, cirrhosis, and hepatic failure, in addition to the hematological complications including DIC and TTP secondary to ecstasy abuse. Ecstasy abuse should be considered in every patient with unexplained hepatic or hematologic complications.