Intravenous drug use is an increasing social problem. Repeated venepunctures, injection of insoluble substances and needle sharing habits in intravenous drug users result in complications leading to admissions under various medical specialities. Many of these patients, however, manifest soft tissue wounds requiring specialised care from plastic surgeons. Typical presentations include injection site related abscess, cellulitis, necrotising fasciitis and non-healing wounds. We present a series of 11 consecutive cases treated in our unit over a six-month period, to highlight the varied clinical presentations and potential difficulties in their management.