Methanol poisoning remains a major public health concern due to its high lethality and risk of permanent visual impairment.

To describe the epidemiology of methanol poisoning in Morocco over a 44-year period and to document outbreaks with a focus on risk assessment and clinical management.

We conducted a retrospective cross-sectional study on the period from 1981 to 2024 using the national toxicovigilance registry of the Moroccan Poison Control and Pharmacovigilance Center (CAPM). Only confirmed methanol poisoning cases were included, and the data collected comprised sociodemographic characteristics, circumstances of exposure, implicated products, and clinical outcomes. Descriptive analyses were performed, and risk management strategies were reviewed.

A total of 848 cases were recorded, with a case-fatality rate of 13% (110 deaths). Two major peaks occurred in 1997 (88 cases) and 2024 (201 cases). The products involved in the poisonings were adulterated alcohol (45%), methylated spirits (42%), brandy (8%), and unspecified methanol containing products (5%). Eleven outbreaks were repported, with lethality ranging from 6% to 100%. Most victims were men aged 20–45 years. Ocular sequelae, including blindness, were frequently reported.

Methanol outbreaks primarily occur in the context of informal alcohol distribution. The main preventive actions should include strengthening regulatory control, ensuring the availability of antidotes and extracorporeal treatment (ECTR), implementing standardized management protocols, and conducting targeted prevention campaigns.