Four siblings presented with vomiting, diarrhea and miosis following ingestion of the plant. This is the first report of miosis as a presenting sign of Jatropha intoxication. The combination of vomiting, diarrhea and miosis resembles the clinical presentation of organophosphate poisoning. This fact warrants the consideration of Jatropha ingestion in the differential diagnosis of organophosphate ingestion. Treatment of Jatropha intoxication is supportive with emphasis on rehydration. Measurement of plasma acetylcholinesterase activity levels, which is normal after Jatropha ingestion and decreased following organophosphate poisoning, may help differentiate between the two.