The use of psychoactive substances (PS) in the population is a current problem that affects a large part of humanity, with diverse consequences. To analyze the factors associated with the consumption of PS among men who have sex with other men (MSM) in three Colombian cities. This cross-sectional descriptive study used the respondent-driven sampling (RDS) method and obtained a sample of 1301 MSM. The association between the sociodemographic and personal characteristics and the consumption of PS was assessed using the chi-square test. Prevalence ratios were calculated along with their 95% confidence intervals. For the multivariate analysis, a Poisson regression with a log link and robust estimator was employed to explore the factors associated with PS use. The prevalence of consumption of PS in the last year was 87%, prevailing the consumption of alcohol, marijuana, and poppers. Having occasional partners (PR: 0.44; 95% CI 0.29 - 0.67), attending public places or establishments such as bars and saunas (PR: 3.39; 95% CI 2.34 - 4.91), sex work, and not using a condom in the last sexual encounter (PR: 2.10 95% CI 1.37 - 3.22) are factors associated with the use of these substances. There is evidence of a high prevalence of recreational use of PS, even higher than that found in the general population. A high prevalence and association with risky sexual behaviors is confirmed, which requires promotion and prevention actions to reduce the use of these substances.