Cocaine abuse has an overwhelming effect on the healthcare system due to its multiple complications. Cardiovascular complications carry the highest burden. Common cardiovascular manifestations of cocaine are related to its adrenergic effects due to the inhibition of dopamine and norepinephrine uptake at the postsynaptic terminal. However, chronic abuse can lead to desensitization of adrenergic receptors, which can lead to bradycardia. Sinus bradycardia can be one of the markers of chronic cocaine abuse, as exemplified in this case report. Therefore clinicians should be aware of this association.