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Aim: The use of amphetamine-type stimulants (ATS) such as methamphetamine and ecstasy (MDMA) tends to commence in the late teens and early twenties. Presently ATS use in Australia is most common among young adults (those aged 18 to 25 years). However, our understanding of the natural history of ATS use during early adulthood is limited; to what extent does ATS use escalate, and what factors might predict such escalation? Methods: The Natural History Study is a retrospective/prospective longitudinal study examining the natural history of ATS use during early adulthood (ages 18 to 23 at baseline). A group of ATS users (N = 352) and a comparison group of non-users (N = 204) were recruited randomly using population screening methods. Main group participants had used ecstasy or amphetamines 3+ times in the last 12 months and the comparison group had never used either drug at the time of screening. Results: Population screening data indicated that 22.9% of males (N = 2658) and 21.2% of females (N = 3400) aged 18–23 years in Brisbane and the Gold Coast had ever used ecstasy, while 12.2% and 10.2% had used amphetamines. The lifetime and 12-month prevalence of ATS use was signifi cantly higher among older users within this age range. However, among the ATS sample frequent (at least weekly) use was uncommon at baseline and follow-up over a 12-month period (approximately 9% of users at each interval). Escalation of ATS use occurred among a small minority of the participants who were using occasionally at baseline. While many young adults persisted with ATS use, older age and structured commitments (i.e. work and study) were signifi cant predictors of less frequent use. Conclusions: The frequent use of methamphetamine and, in particular, ecstasy is uncommon among young adult users of these drugs, and the frequency and continuity of use appear to be closely linked with maturational and structural factors.