To determine emergency management of overdose relating to gastrointestinal decontamination procedures in Scottish Accident & Emergency (A & E) Departments. A postal questionnaire was sent to the 28 main A & E Departments in Scotland. There was a 75% response rate. Nineteen departments(90%) continue to perform gastric lavage, with the majority carrying out this procedure more than one hour post-ingestion of commonly presenting overdoses. Sixteen departments (76%) regularly administer activated charcoal and four (19%) use syrup of ipecacuanha. Twenty departments (95%) had access to Toxbase. The majority of respondents (86%) feel there is a need for standardisation of treatment in acute overdose. Despite the availability of guidelines provided by the UK National Poisons Information Service and the Position Statements, there is no consensus in the actual management of acute overdose among Scottish A&E departments.