Much of the available literature on the epidemiology of “club drugs” among men who have sex with men (MSM) derives from studies conducted on the west coast of the United States, as well as in Australia and Western Europe. Little data are available about club drug use from east coast United States cities, most particularly New York City (NYC), with its large and complex MSM population and highly elaborated set of MSM social venues. This paper describes findings from an epidemiological study of young men who have sex with men (YMSM) in New York City. A total of 569 YMSM completed an interview protocol, which was conducted using a computer assisted personal interview format with domains consisting of demographic characteristics, sexual identity, educational attainment, history of housing instability, involvement with the criminal justice system, exposure to violence and victimization, mental health status, both lifetime exposure to and current use of illegal drugs, and sexual risk assessments. High levels of lifetime exposure, as well as chronic club drug use are reported in this sample. Rates of drug use, including club drugs, substantially exceed previous estimates of this population. Chronic club drug users evidenced high levels of mental health difficulties, including both a history of suicide and current depression. However, the data show that the onset of mental health difficulties predate exposure and onset of drug use. Tables, references