Introduction: The communal and repeated use of injection needles predisposes injecting drug users to several complications. Report: This case report describes uncommon cardiac and pulmonary complications in a 44-year old male, injecting drug abuser. The retention of fractured injection needles in the groin, and the subsequent embolisation to the right ventricle, predisposed to recurrent systemic infections, and cavitating pulmonary septic emboli and pleural empyema as well as local complications. Years later, the needle was completely embedded in the wall of the right ventricle and not suitable for transvenous removal. Discussion: Continuing intravenous drug abuse with injections into the groin result in infective complications, commonly pseudoaneurysms of the distal common femoral artery requiring triple femoral ligation. The embolisation of a fractured injection needle to the RV is a clinical rarity.