Patient: Male, 27Final Diagnosis: Carbon monoxide poisoningSymptoms: Dizziness • nausea • SyncopeMedication: —Clinical Procedure: O2 treatmentSpecialty: AnesthesiologyObjective:Challenging differential diagnosisBackground:Carbon monoxide (CO) poisoning is commonly seen during the winter season in Turkey due to use of charcoal stoves and water heaters, but narghile smoking is a rare cause of CO poisoning.Case Report:In this paper, we report a CO poisoning case caused by narghile smoking. The patient was admitted to the ED with nausea, dizziness, vertigo, and syncope.Conclusions:The diagnosis of CO poisoning depends on suspicious anamnesis. The major treatment of CO poisoning is oxygen supply.