A 3,200 gm 12-day-old male infant with complex urologic problems underwent charcoal hemoperfusion for severe accidental chloramphenicol intoxication. Immediately prior to CH, with a serum chloramphenicol level of 98 micrograms/ml, the child was in profound shock, ashen-gray, hypothermic, and acidotic. Chloramphenicol levels indicated virtually complete removal of this drug by the CH column. Three hours of CH treatment resulted in a reduction of the chloramphenicol level to 13.5 micrograms/ml and complete reversal of the described clinical syndrome. No serious complications of CH were encountered. We conclude that chloramphenicol poisoning is treatable by CH and that this therapeutic modality may be safely carried out in infants and small children.