BACKGROUND: Concerns about gay men's methamphetamine use reflect its physical and psychological harms, and association with sexual-risk behaviour and HIV infection. Existing research suggests gay men's use in the UK is low and may be largely confined to London. METHODS: Cross-sectional survey of convenience sample of UK gay men. RESULTS: Methamphetamine was used by a significant minority of gay men in London but also in other regions. Overall, use was highest among those men aged 30-49, HIV-positive and reporting sexual-risk behaviours. CONCLUSION: Methamphetamine was used by a significant minority of gay men in and outside London. Targeted prevention and treatment services should be developed and evaluated.