The present study was to assess the DNA damage and oxidative stress occurring in patients chronically abusing Tramadol. The present study was carried out on 120 subjects who were classified into two groups; Group-I (control group) which included 20 healthy persons not addict to any drug of abuse, and Group-II (study group) which included 100 patients of both sexes of Tramadol abusers who sought medical advice at National Environmental and Clinical Toxicological Research Center (NECTR), Cairo University Hospitals. Tramadol abuse patients had been subjected to submit history on (demographic data, history of abuse, medical and psychological history, history of complaints associated with Tramadol abuse).