Paracetamol is a low cost, effective analgesic that is widely available in the UK. Paracetamol is the drug most commonly taken in overdose and can lead to acute liver failure, which can be fatal. This article focuses on the assessment and management of paracetamol poisoning in adults. It includes current UK guidelines on paracetamol poisoning, which changed in September 2012 following a review by the Commission on Human Medicines. It also discusses strategies to reduce incidence and severity of paracetamol poisoning, and outlines the metabolism of paracetamol at therapeutic doses and in overdose.