Poisoning by cytotoxic mushrooms is associated with severe morbidity and a high mortality rate. Due to the poor knowledge of the pharmacodynamics of toxins, there are conflicting results about appropriate treatment, particularly the efficacy of detoxification. The detoxification treatment should ideally be initiated early to minimize the toxic exposure of highly susceptible cells. Therapeutic strategy comprises elimination methods such as gastrointestinal lavage, charcoal administration, forced diuresis and extracorporeal detoxification techniques. Among these techniques, hemoperfusion and plasmapheresis are the most effective procedures of all. Early and comprehensive treatment are essential.