The study aims to describe ayahuasca users in Estonia and compare their mental health and quality of life to those of nonusers. Ceremonial practices, motivation for ayahuasca use, use-related experiences, and subjective consequences of use are described. We conducted a cross-sectional casecontrolled study of thirty ayahuasca users and thirty nonusers matched by gender, age, and education. The participants completed questionnaires, standardized psychometric tests, and neuropsychiatric interviews. Ayahuasca use in Estonia occurred mainly in (neo)shamanic group ceremonies. The main motives for ayahuasca use were spiritual development, self-knowledge, and spiritual experiences. The users reported mostly positive subjective consequences of ayahuasca use for their health and life. However, some di!cult experiences and adverse e"ects were reported. No abuse of ayahuasca or addiction to it was found. Screening test indicators of depression and anxiety were lower in the ayahuasca-using group. No deterioration of the mental health of ayahuasca users in comparison to nonusers was found. The participants perceive their use of ayahuasca as a spiritual practice with mostly favorable outcomes for their health and life. They also perceive ayahuasca use in Estonia as a reasonably safe and self-limiting form of spiritual practice.