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Objective: Preclinical research and cognitive neuroscience implicate the hippocampus as a critical node in the neurobiology of drug addiction, as is vividly illustrated in this clinical case study. Method: The patient, JD, was a 52-year-old male with a long history of severe cocaine use disorder who sustained a bilateral ischemic stroke to the hippocampus due to a cocaine-related overdose. He was evaluated at the initial injury and at 12-month follow-up. Results: While hospitalized, neuropsychological assessment revealed both severe 2-year retrograde amnesia and anterograde amnesia with preserved global cognitive functioning. At 12-month follow-up, JD exhibited a similar neuropsychological profile. Most significantly, JD reported full sustained remission of cocaine use disorder at follow-up, without cravings or effort to achieve this outcome and despite intact declarative and autobiographical memory of his past cocaine use. His remission was confirmed by his son with whom he lived. A 12-month follow-up 3T MRI confirmed bilateral total hippocampus volumes in <1^st%ile compared to normative nomograms. In addition, high-resolution segmentation of the hippocampus comparing JD to a healthy community sample revealed that the largest differences were in the hippocampal tail , CA1 subfield, CA4 subfield, dentate gyrus, molecular layer, and fimbria of the hippocampal body. Conclusions: JD's case reveals the essential role of memory systems subserved by the hippocampus in maintaining addiction, even in the presence of declarative historical memories. Moreover, although no longer relevant for JD, this case underscores the importance addressing the memory systems in addiction treatment.