Shahroud University of Medical siences Shahroud Journal of Medical Sciences 2423-6594 11 1 2025 06 22 Successful management of aluminum phosphide (ALP) poisoning in a teaching hospital in Shahroud: A case report 27 31 eng Tahereh NaseriBooriAbadi Department of Health Education and Promotion, School of Health, Arak University of Medical Sciences, Arak, Iran. Department of Health Information Technology, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran. Seyed Meysam Yekesadat Department of Clinical Sciences, School of Medicine, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran. Farideh Sadeghian Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran. 2025 05 31 2025 03 31 In Iran, herbal or chemical rice tablets containing ALP protect grains from pests. Deaths have been reported following both accidental and intentional exposure to aluminum phosphide. A 20-year-old woman who intentionally ingested a 3-gram ALP tablet and became poisoned is the primary focus of this case report. It outlines the successful management of a patient who had taken a rice tablet and suffered from acute cardiogenic shock, severe metabolic acidosis, and severe hypotension. This patient survived successfully despite the higher mortality rate due to cardiac and multi-organ problems from exposure to phosphine gas, particularly the rice tablet and cellular hypoxia. In addition to daily supportive therapies, an antioxidant regimen, glucose, insulin,  and potassium (GIK), and prompt intubation to improve cardiac function assisted with the recovery.