Farm work, like any occupation, has risks. When faced with an acutely ill farmworker, a clinician must quickly obtain a history with attention to occupational risks, perform a physical examination, and formulate a differential diagnosis. Considerations include exposures to farm chemicals; extremes of weather such as heat waves, blizzards, and lightning strikes; toxic gases; arthropod bites and stings; and snake bites. Infectious diseases should be considered along with travel history given the widespread use of migrant farmworkers.