Exposures to toxic substances is common in disaster settings, either as a direct result of the disaster itself (e.g., a large-scale chemical spill at an industrial site) or as a downstream effect (e.g., carbon monoxide exposure from a resultant fire.) Attending to emergency preparedness, appropriate disaster scene staging, prompt decontamination of victims, and the use of proper personal protective equipment can all help minimize casualties and secondary exposures. Recognition of key physical exam findings indicative of a toxidrome can offer clues as to the specific toxicant(s) involved, but many patients present with only a partial toxidrome or without a toxidrome despite exposure. Though specific treatments and antidotes are indicated for certain poisonings, high-quality supportive care is the definitive management for the vast majority of toxic exposures. Of note, children are uniquely susceptible to toxicologic exposures due to their underlying anatomy and physiology.