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A 20 year old man presented after taking the recreational drug ecstasy. He had dysphagia, difficulty breathing when lying flat, drooling, and a muffled voice. Examination of his oropharynx showed an isolated non-erythematous large swollen uvula that obstructed the oropharynx, known as uvula angio-oedema. He was given 20 mg chlorphenamine and 8 mg dexamethasone intravenously immediately and admitted to the intensive care unit in case his airway was obstructed. Uvula angio-oedema is known to be caused by Ecbalium elaterium, angiotensin converting enzyme inhibitors, thermal injury, hypersensitivity reactions, cocaine, and amphetamines. The causal agent in these last two may be a common mixing agent, used to increase the volume of the drug.drug.