Brown-Sequard Syndrome is a condition caused by unilateral spinal cord injury, presenting with ipsilateral pyramidal weakness and loss of large fiber, including vibratory and proprioceptive sensations, and contralateral loss of pain and temperature. Penetrating injury is the most commonly described cause [1]. Brown-Sequard Syndrome occurring following esophageal sclerotherapy for varices with recent cocaine use has been reported only once in the literature [2], but in that case there were two competing factors which could have independently contributed to the condition. We describe the first case, to our knowledge, of a Brown-Sequard syndrome in which cocaine alone was likely the only external etiologic agent.