The objective of this study was to determine the frequency, principal diagnoses, and correlates of emergency department (ED) visits made by persons with a history of crack-cocaine use (n = 333) over a 3-year period. Data were collected from participant self-reports and hospital records. During the study at total of 643 ED visits were made by 211 people, ranging from 53.5 to 76.7/100 persons/year. Injury and poisoning accounted for the largest single category of ED visits (29.5%). Men had lower odds of visiting the ED (OR = 0.79, 95%CI = 0.62-0.99), as did participants with higher levels of education (OR = 0.83, 95%CI = 0.73-0.94). Number of times in drug abuse treatment (OR = 1.04, 95%CI = 1.01-1.09), having a chronic disease (OR = 1.46, 95%CI = 1.06-1.99), and higher Addiction Severity Index composite medical scores (OR = 1.62, 95%CI = 1.15-2.29) increased the odds of an ED visit. Factors in addition to drug use are likely to affect ED utilization rates among crack-cocaine smokers.