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Ketamine is an N-methyl-D-aspartate glutamate receptor antagonist used primarily as an anaesthetic agent and analgesic. Recreational use in the UK became widespread in the 1990s and recent evidence shows a preponderance in 16–24 year olds. Its hallucinogenic and dissociative effects are the likely cause of its popularity as a recreational drug. Ketamine, when used recreationally, is often inhaled, snorted and rarely ingested orally. This report describes a case of recurrent abdominal pain due to ketamine misuse, colloquially named “K-cramps”, exploring its clinical presentation, the diagnostic process and potential management strategies for this underreported condition.