Scleroderma renal crisis is a clinical syndrome of systemic sclerosis that is classically characterized by accelerated hypertension, rapidly progressive renal failure, and hyperreninemia. It has been reported that cocaine may initiate scleroderma in an already susceptible individual or unmask it at an earlier age in subclinical disease. We describe a 46-year-old male patient with a history of heavy cocaine abuse that unmasked scleroderma and precipitated scleroderma renal crisis.