Family physicians often manage substance ingestions in children, most of which are nontoxic in nature. Physicians should know the phone number of the poison control center, understand the appropriate initial assessment of suspected toxin ingestion, and recognize important toxidromes. Rapid triage is crucial, including airway, respiration, and circulation stabilization. Appropriate supportive or toxin-specific treatment should be initiated. Gastric decontamination, such as activated charcoal and gastric lavage, are no longer routinely recommended. These methods should be reserved for the most severe cases, with poison control center support. The use of ipecac is no longer recommended. A child with few symptoms or a witnessed toxin exposure may be monitored at home. However, some long-acting medications have delayed toxin effects and require additional surveillance.