The objective of this review is to assess the hazardous effects of substance abuse in Ethiopia. Substance abuse is a maladaptive pattern characterized by repeated adverse consequences related to the repeated use of the substance. Alcohol, khat and cigarettes are commonly used substances in urban as well as rural areas. In this review first we stated the hazardous effect of substance abuse and then identifying the most commonly missed substance use and their legal consideration. In order to prevent and control the substance abuse is developing and implementing of laws and policy are important especially for developing countries like Ethiopia. Alcohol, khat and tobacco/cigarettes were reported to be commonly used. Substance abuse is recognized to be an emerging problem in Ethiopia; only limited information is available in the literature. The adverse impact of substance use on mental health, physical health and social wellbeing of students was also stated but not well reported. There is legal consideration from the Ethiopian proclamation and polices but still there is no clear and enough laws regarding for drug abuse.