BACKGROUND: Despite low levels of motivation and perceived need for professional support among methamphetamine users, there is a lack of research examining self-perceptions of non-problematic use and their relationship with methamphetamine use patterns and experience of associated harms. METHOD: Regular methamphetamine users (N=255) were recruited in metropolitan Melbourne, Australia, during 2010 and administered a structured questionnaire. RESULTS: Forty-one percent of participants reported that their use was not problematic or harmful enough to warrant accessing professional support. In multivariate logistic regression analyses those who perceived their use as non-problematic generally engaged in less risky methamphetamine use patterns, experienced fewer associated harms and were more likely to be employed than those not perceiving their use as non-problematic. However, half of the ‘non-problematic’ participants were classified as methamphetamine-dependent using the severity of dependence scale and most reported recently experiencing significant methamphetamine-related harms, suggesting a degree of unrecognised need. CONCLUSION: Our findings highlight the issue of perceived need as a key barrier to methamphetamine service access and the sustaining of such barriers in individuals over time. They emphasise the importance of addressing the service needs of different methamphetamine using populations.