We have described a case of child abuse by intentional poisoning with forced salt feeding. The serum sodium level reached 184 mEq/L, with a concomitant urinary sodium value of 360 mEq/L. Treatment with rapid infusion of normal saline brought the serum sodium level to 151 mEq/L after eight hours, without complications. Child abuse by intentional poisoning appears to reflect greater psychopathology than other forms of abuse.