Aims: Methamphetamine (meth) is a powerful, highly addictive stimulant that affects the central nervous system, and its side effects may result in severe self-mutilation. This report describes a case of a meth user with severe oral injury that demonstrates the necessity for prompt treatment when severe tongue biting occurs.Methods And Results: A 43-year-old meth-using man with severe tongue biting was left untreated for more than 24 hours, resulting in extensive ischemic changes in the tongue and eventual extensive tissue necrosis.