Acetaminophen is the most widely used analgesic drug in pediatrics. It is also the most frequently ingested drug in overdoses. The incidence of paracetamol poisoning has increased and it is accompanied with high morbidity and mortality. The use, abuse and ways of reducing paracetamol toxicity are reviewed. A case report of lethal acetaminophen intoxication in 2-year-old child is described. Authors draw attention to the health care providers--they should consider acetaminophen toxicity in all cases when the child has signs of acute hepatic dysfunction.