MDMA (3,4-methylenedioxymethamphetamine, ecstasy) is a psychostimulant drug of abuse that causes hyperthermia, toxicity, brain damage, and cognitive impairments. This chapter focuses on the effects of MDMA on gene expression in the brain. Changes in gene expression upon MDMA administration have been assessed only in animal models, not in humans. Several genes are differentially expressed as a first response to stimulation, a few hours after MDMA intake. Several hours later, many genes involved in neurotransmission show altered expression patterns. Also, the expression of genes involved in inflammatory and immune responses is enhanced, and is more pronounced when animals are exposed to chronic administration. Several days after intake of MDMA, an altered expression of genes involved in neuronal adaptations is observed, which may be involved in the recovery of neuronal function and readaptation of brain circuits.