Bismuth subcitrate is a known nephrotoxic agent that may lead to acute oliguric renal failure when ingested in toxic doses. We report a 17-year-old girl who was admitted to the emergency room with complaints of nausea, vomiting, and anuria. She had taken 25 tablets containing 300 mg bismuth subcitrate (total 7.5 g). The patient was managed with hemodialysis started a week after ingestion. Bismuth subcitrate nephrotoxicity should be considered in the differential diagnosis of acute renal failure. Copyright (C) 2002 S. Karger AG, Basel.