We report a case of gastric perforation in an 18-year-old girl as a result of ingesting an alcoholic drink containing liquid nitrogen. The drink was purchased in licensed premises. The extent of the injury necessitated total gastrectomy with Roux-en Y reconstruction. We review the literature, discuss the mechanism of injury and consider the implications for medical services. The authors believe this case is of educational interest to professionals working in emergency medicine, general surgery and public health fields. It raises awareness of a rare injury, but one that may be more commonly encountered because of developing social trends. It informs surgeons confronted with this type of injury that trauma to the gastrointestinal tract can be extensive and preoperative contact with oesophago-gastric colleagues is advisable. Public health bodies must be aware of, and monitor, the use of liquid nitrogen in this way and consider regulation to prevent further injuries.