Valproic acid is used in crisis management both simple and complex absence, myoclonus and tonic-clonic seizures. It is effective in partial seizures, as second line prophylaxis for migraine and bipolar disorder. Its widespread use has increased cases of poisoning in recent years. The aim of this review is to describe the clinical manifestations and evolution of a severe valproic acid intoxication secondary to intentional consumption as well as emphasize the importance of drug metabolism for clinical management of poisoning, the need for a laboratory provide rapid quantification of this drug and discuss current treatment options.