Pine oil is a common component of household cleaning solutions. We present the case of an elderly woman with dementia who ingested a household cleaning solution that contained pine oil and review the treatment of pine oil ingestion. The patient developed CNS depression and respiratory failure that required intubation and mechanical ventilation. A chest radiograph revealed diffuse alveolar interstitial infiltrates consistent with pneumonitis. The patient improved with supportive care. However, she developed nosocomial pneumonia, sepsis, and multiple organ failure and subsequently died. This case is illustrative of the increased risk for ingestion of toxic household compounds in the growing population of elderly and demented individuals, who are being cared for in the home. Pine oil ingestions are one of the most common accidental ingestions encountered in clinical practice. Clinical features of ingestion include depressed mentation, respiratory failure, and GI dysfunction. The treatment is supportive, and the ingestions are rarely fatal.