Intravenous drug abusers often resort to deep cervical venous access if peripheral access is problematic. Deep cervical injection can occasionally result in needle breakage and needle foreign body. The records of 50 patients with neck needle foreign bodies related to intravenous drug abuse treated at The Johns Hopkins Hospital were reviewed retrospectively. Only half of these patients presented to this hospital with a complaint of a neck needle. Complications related to neck needles were manifested in 5 (10%) of the patients at the time of initial presentation. No delayed complications occurred. Human immunodeficiency virus seropositivity for this group of patients was 77% compared to a rate of 29% for all intravenous drug abusers at the same institution. The demographics and management of neck needle foreign bodies are discussed, and the importance of recognition of neck needle foreign bodies is emphasized.