Cocaine abuse during pregnancy is associated with a significant increase in obstetric complications: i.e. premature labour, premature rupture of membranes, abortion, eclampsia, and placental abruption. Infants of cocaine-addicted mothers present with an increased incidence of low birth weight, congenital defects, respiratory distress, hypotonia, and seizures. Moreover, infants exposed in utero and through breast milk to cocaine present with an higher risk of cerebral ictus, impaired kidney function and intestinal ischemic injury with perforation or NEC. The paper describes a case of isolated intestinal perforation in the newborn of a cocaine-addicted mother. The case is characterized by the absence of associated risk factors present in the other cases described in the literature.