OBJECTIVES: To review the literature, covering the most important aspects of management of acute poisoning.METHODS: The most relevant articles on the management of acute poisoning were selected.RESULTS: Acute poisoning is an important matter of public health, particularly for the child. Medicaments are the main responsible agents followed closely by accidents with poisonous animals and household chemical products, pesticides and industrial products. The management of the poisoned patient must proceed through the following sequential stages: initial clinical evaluation and stabilization of the patient, when life-threatening situations are identified and treated; recognition of the toxic syndrome and identification of the causal agent, when the careful analysis of the signs and symptoms help choosing the diagnostic tests; decontamination, with the careful use of the available methods; administration of antidotes, which are small in number and should never delay the other phases; enhancing the elimination of the absorbed toxic, which requires knowledge of the kinetics of the toxic substance; and supportive treatment.CONCLUSIONS: The recognition of the toxic syndrome and knowledge of the phases of management are basic conditions for the success of treatment.