With a blistering 1.57 million on the Scoville heat scale, the Carolina Reaper is not a chilli to be messed with.
But despite its name and gnarled appearance, some people still eat these insanely hot chilli peppers for fun - or peer recognition.
According to a new case study in The British Medical Journal, a 34-year-old man from New York did just that during a hot pepper eating contest - and ended up in hospital.
He developed neck and head pain after ingesting the chilli, and then the headaches began.
"During the next few days, on at least two occasions and in retrospect he thought probably more often, he experienced brief intense thunderclap headaches lasting seconds," wrote the researchers from the Bassett Medical Center, Cooperstown NY.
"The pain was excruciating and thus he came to the ER."
A thunderclap headache is a very severe headache that lasts a short amount of time – usually seconds or minutes of intense pain.
When the doctors did tests on the patient, including an MRI and CT scan, everything appeared normal.
But they did discover that a few blood vessels in the brain had changed – sections of his internal, middle and posterior cerebral arteries had all narrowed.
This condition is known as reversible cerebral vasoconstriction syndrome (RCVS), and was most likely causing the thunderclap headaches.
This can sometimes happen by medications or drugs, but a urine test revealed the patient's system was completely clean. The doctors now think that the chillies were to blame.
"Given the development of symptoms immediately after exposure to a known vasoactive substance, it is plausible that our patient had RCVS secondary to the 'Carolina Reaper'," the researchers concluded.
What's interesting is this isn't even the first time chilli peppers have caused these kinds of problems.
"When we were looking at the literature we found a couple of cases similar to our case," one of the researchers, Kulothungan Gunasekaran of the Henry Ford Health System in Detroit, told The Guardian.
But even though they're certainly up there in insanity, the Carolina Reaper and Ghost Pepper aren't even the world's hottest chillies.
The hottest currently is called Pepper X, with an unverified Scoville score of 3.18 million. Coming in second place is Dragon's Breath with alleged 2.48 million.
Although chillies can have a bunch of health benefits, the record-breaking ones might be best left alone, unless you want to become a weird medical case.
This case study has been published in BMJ Case Reports.