Hydrogen cyanamide, a widely used agricultural chemical, is primarily employed as a dormancy-breaking agent in fruit crops. Despite its benefits in enhancing bud break and synchronization, exposure to hydrogen cyanamide poses significant health risks, particularly through dermal contact or inhalation. Toxicity can result in a spectrum of adverse effects, ranging from mild irritation to severe systemic reactions.

We report a case of acute occupational hydrogen cyanamide toxicity in a previously healthy agricultural worker who presented with altered mental status and visual hallucinations associated with characteristic skin lesions shortly after exposure that responded successfully to supportive management.

By highlighting the clinical presentation, and treatment strategies, this report highlights the importance of recognizing the toxic profile of hydrogen cyanamide to enhance awareness among healthcare professionals and contribute to improved safety protocols and appropriate protective measures for individuals dealing with this chemical in agricultural practices.