This paper examines the stigma of injecting drug use as an underlying factor in the poor health status of Australian injecting drug users. Drawing on various models of stigma described in the literature, we examine injecting drug users’ experiences. As a case study, examples from Victorian (specifically Melbourne) policy and practice are included to exemplify community and societal attitudes towards injecting drug users and the implications of these for injecting drug user health. We conclude that redressing the negative effects of stigma requires political will, financial support, increased community commitment and a better understanding of the links between the social determinant of health and the poor health status of injecting drug users. Without reducing the stigma of injecting drug use the health of this marginalised population is likely to get worse, which will have broader negative population health effects.