Volatile substance abuse (VSA) is an under-recognized worldwide problem. Data, especially international comparisons, are limited. The 2005 ESPAD report published data on VSA from 35 countries, collected in 2003. Lifetime prevalence of VSA can be as high as 22%, with little difference between boys and girls in most countries. Perceived risk of VSA is worryingly low (comparable to perceived risk of cannabis), varies greatly between countries, and does not seem to be related to levels of use within countries. Neither is perceived availability of volatile products related to national prevalence rates of misuse. International comparisons must be approached with caution, but this report gives useful data on an under-researched issue.