The emerging nation of South Africa, in common with some other countries, notably Eastern Europe, is heir to decades of neglect with regards to the exposure of the majority of its population to toxic materials. In this short review, the major toxic health hazards are described. For most of these risks there are now programs in place to improve the situation, but co-ordination and financial constraints, along with the fact that the majority of the population neither live, nor work, in a controlled environment, mean that much remains to be done. The recent formation of a South African Toxicology society, which strives to bring together environmental, industrial, forensic and clinical toxicology should assist in an improvement, both in the epidemiology of toxicity in South Africa and in improved measures to reduce the incidence of preventable noncommunicable diseases related to both acute and chronic exposure to toxins. The South African scene also provides a "window' of opportunity to study the more fundamental aspects of exposure in human subjects and to couple these to animal and in vitro studies to elucidate the underlying mechanisms where these are unknown.