Chemsex is the intentional use of substances in sexualized settings among men who have sex with men. An increasing public health issue, chemsex has estimated prevalence rates of 3% to 29% in men who have sex with men. Known risks of chemsex include higher exposure to HIV and other STIs, addiction, and cardiovascular problems. Recent research has also shown that chemsexers are prone to depression, anxiety, psychotic experiences, and cognitive impairment. Our commentary highlights the discrepancy between the public health burden associated with risky chemsex practices and the research gap in this domain. We warn against the simplistic application to chemsex of existing theoretical concepts or therapeutic strategies that work for addictions and at-risk sexual behaviours. Such an approach neglects the unique features of this emerging phenomenon, which mainly affects stigmatized minorities.