Anabolic steroid use is widespread and has been associated with a variety of pathological conditions. The subject of this case is a 20-year-old amateur bodybuilder who died of sudden cardiopulmonary arrest. He had no previous medical complaints but had a history of anabolic steroid abuse and a hypertrophic heart (515 g) at autopsy. This case presentation will discuss the cardiovascular effects of these drugs and the possible impact of long-term abuse.