Two fatal cases of poisoning by paracetamol are described. Both patients were heavy imbibers of alcohol and both had swallowed less paracetamol that that generally regarded as a lethal dose. The biochemistry of paracetamol hepatotoxicity is outlined and the increased susceptibility of alcoholic patients to the hepatotoxic effects of paracetamol is remarked upon. Recent trends in the treatment of acute paracetamol poisoning are mentioned.