Introduction: The cocaine consumption grew considerably in Brazil due to the popularization of crack, smokable form of cocaine with great power of dependence induction, low cost and easy attainment, which reaches a poor population, with little access to the health system. In medical literature there are some studies about the acute otolaryngological alterations caused by the consumption of crack, however few studies mention the chronic alterations caused by the drug. Patients and Methods: We evaluated the main otolaryngological manifestations in 18 patients handling in the Psychiatry Institute of the HCFMUSP, with history of chronic use of crack, found through anamnesis, full ENT physical examination and fiberoptic examination. Results: The great majority of the patients had oropharyngeal and laryngeal complaints related to the consumption of the drug. The main alterations were the presence of edema and hyperemia in supraglottic region. Conclusions: The presence of hyperemia in supraglottic region is an unspecific finding that should be valued for the diagnosis of the drug consumption.