A 31-year-old man presented with abdominal pain and vomiting with a smell of garlic and rotten fish. He was brought to the ER being circulatory affected, metabolic acidotic and he developed more episodes of arrhythmia. Oral poisoning with aluminium phosphide is a very serious condition due to release of the toxic phosphine gas. Treatment is symptomatic. To avoid contamination of the staff is it important to use air-tight containers for excretions and furthermore to use chemical clothing and breathing protection.