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The analgesic, anti-inflammatory, and antipyretic properties of nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used. In many parts of the world, they are commonly taken in excess. The vast majority of patients with acute NSAID overdose will be asymptomatic or will experience minor self-limiting gastrointestinal symptoms. However, serious clinical sequelae such as convulsions, metabolic acidosis, coma, and acute renal failure have been reported in patients with acute NSAID overdose. There appears to be some variation in the relative risk of these complications among the NSAIDs; in particular, mefenamic acid is most commonly associated with convulsions. There are no specific antidotes for acute NSAID toxicity, so management of these serious clinical features is largely supportive.