Abstract : <p>Failure in achieving abstinence in methamphetamine dependence population is a common scenario. The use of methamphetamine in pregnancy however, was not so often brought to attention. This report highlights the challenges and issues encountered in the management of a pregnant lady with the problem of methamphetamine dependence, who presented with psychosis. Among the areas outlined were issues in commencing treatment for methamphetamine psychosis, presence of psychosocial conditions that impeded total abstinence and the risks of methamphetamine use during pregnancy.</p>