Background- Recreational drug use among young men who have sex with men (YMSM) was a public health issue of worldwide concern. Evidence had shown the relevance between recreational drug use and human immunodeficiency virus (HIV) infection. This study aimed to investigate the current prevalence state of recreational drug use among YMSM in Tianjin, discern the characteristics of YMSM who used recreational drugs or not and examine the interaction effect of recreational drug use and unprotected anal intercourse (UAI) on HIV infection.Methods- In 2018, a cross-sectional study was conducted in Tianjin, China. The snowball sampling method was used to recruit YMSM. Participants were recruited from gay bars, gay bathhouses, social network sites (WeChat, QQ, gay chat website), gay apps and peer referrals. Structured questionnaires were used to collect data.Results- A total of 1075 YMSM met the eligibility criteria and were included in the study eventually. The overall HIV prevalence was 4.3% (46/1075). Of all the recreational drugs involved in this study (rush poppers, methamphetamine, capsule No.0), rush poppers (406/517,78.5%) were the most popular among YMSM in Tianjin. Compared with non-drug users, drug users were more likely to have first sex earlier, be bisexual, be male sex worker (MSW), have a higher education level, seek sex partners through physical venues, engage in UAI, have sexually transmitted infection (STI), and receive HIV testing. Moreover, recreational drug use and UAI were associated with the increased risk of HIV infection [adjusted OR:3.6 (95%CI: 1.7-7.6) and 4.9 (95%CI: 2.2-10.4), respectively]. There was additive interaction of recreational drug use and UAI on HIV infection [relative excess risk due to interaction (RERI): 6.949 (95%CI: 0.011‐13.887); attributable proportion due to interaction (AP): 0.809 (95%CI: 0.578‐1.039)].Conclusions- Recreational drug use was common and correlated with HIV infection among YMSM in Tianjin. There was an urgent need to build novel targeted HIV prevention strategies to discern and reduce recreational drug use among YMSM in China.