The self-administered W.H.O. Students Drug Use questionnaire (Smart et al, 1980) as modified and adapted by Akinhanmi (1996) was used to gather data on drug use among medical students at the College of Medical Sciences, University of Maiduguri. This is a Federal Government owned institution located in the north east of Nigeria. The lifetime prevalence use of drugs of abuse among the medical students was 23.7%. Drug use among pre-clinical and clinical medical students were essentially the same except in respect to previous year use of cannabis, where there was a statistically significant difference (2 =8.12, df=1, p<0.001) with the use being higher among the clinical medical students. Alcohol was the most prevalent drug for lifetime use, followed by tobacco, hypnosedatives, cannabis, amphetamines, heroin and opiates. These were followed by inhalant and cocaine use. There was no inhalant use in the previous year and no cocaine use in the previous one month. The use of hallucinogens, such as LSD was not reported at all. Most drug users, 60-90% used the drugs occasionally, 1-5 times drug use a month. Alcohol use was found to be associated with some socio-demographic profiles. Alcohol use was more common among males, Christians and among those who reported that, they rarely or never practice their religion. This study showed that medical students, who hailed from the southern part of Nigeria used alcohol and tobacco more commonly than their counterparts from the northern region, in contrast to the figures obtained by Akinhanmi (1996) and Ihezue (1988a). Also associated with higher alcohol use was parental use of drugs, parental higher education and parents being divorced. Few students reported how they obtained the drugs from hospitals without a doctor’s prescription. However, 10.5% claimed they got the drugs through self-prescription. Perceived easy availability of drugs in the hospital setting, stress or knowledge of drugs by virtue of being medical students were not contributory factors to drug use by the medical students’ in this study. A similar finding to that obtained by Akinhanmi, 1996. The results in the study highlight some differences in the drug use pattern of medical students, who hailed from the northeastern part of Nigeria as compared to the southern part. The reasons for this may include differences in the availability of the drugs in the areas, religious tenets and possibly selection bias. This study calls for a longitudinal national survey of drug use patterns among medical students in Nigeria.