Combine the tequila, Worcestershire sauce, cayenne pepper, and garlic in a blender; blend until smooth. Place the steak on a plate; pour marinade over the steak. Place in refrigerator at least 8 hours or overnight.
Preheat an outdoor grill for high heat and lightly oil grate.
Grill steak to desired degree of doneness, 7 to 8 minutes per side for medium.