Background: Substance abuse is rapidly growing with changing patterns of substance use. There is a substantial amount of data as regards the correlation between drug abuse and injuries managed in the emergency department (ED). Objective: The aim of the current work was to estimate the incidence of substance abuse related medical disorders among patients presented to Mansoura Emergency Hospital and the outcome of management of those cases Patients and methods: This prospective observational clinical study included a total of 250 patients arrived at ED, Emergency Hospital-Mansoura University with positive history of drug abuse and verified by Urine drug screening. Results: The incidence of substance use disorders (SUDs) among the studied cases was 11.2%. There were statistically significant correlations between toxicological screening results and studied cases presentation to emergency department.Male gender, single status, younger age and low income were the most frequently involved factors. Drug abusers were significantly increased among smokers. Conclusion: Of all adult patients presented to ED at Emergency Hospital-Mansoura University, about 10% of them had SUD. They were mostly male, single, younger age with unsatisfactory income. The outcomes focus on the significance of the potential roles of the ED as a site for interventions aimed at reducing harm from SUDs.