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Body packing is a way to deliver packages of drugs hidden in body cavities. In Europe, as noted the latest report coming from the Brussels observatory, there are 74 million drugs consumers. Italy is in pole position and Perugia was considered as a “capital city” in the drug market. Body packers usually swallow the drug packets, although their insertion into the rectum and vagina has also been reported. The management depends on whether or not the patient becomes symptomatic. Surgery is indicated in presence of repeated bouts of drug toxicity not controlled by medical treatment, radiological evidence of packet retention in the stomach, intestinal obstruction or perforation. It is also important to emphasize that, in a multidisciplinary context, the patient’s management before reaching the operating theater if symptomatic, is aimed to stabilization and is usually demanded to Intensive Care Unit (ICU) physicians. We present our center recent experience with body packers, managed both with surgical and conservative treatments.