Cocaine is wrongly held as a benign recreative drug whereas it is a highly addictive substance with possible dreadful cardiac and neurologic complications. Cocaine abuse results in patchy cerebral hypoperfusion and hypometabolism, clearly demonstrated by PET and SPECT imaging. Improvement after drug withdrawal is still unclear Cocaine binds with a very high affinity to the dopamine reuptake transporter: Labelled cocaine congeners can be used to assess dopaminergic pathways, especially nigrostriatal neurons that play a key role in movement control. I-123 labelled beta-CIT can reproducibly be used to measure dopamine transporter density in the striatum, in one day. This approach seems very promising.