Hydrogen sulfide poisoning is a rare but devastating injury. Four of 8 cases of toxic inhalation of hydrogen sulfide are presented with special attention to the life-threatening complications. Four patients died at the scene of the accident and the remaining 4 had been hospitalized in the Intensive Care Unit (ICU). One patient died in the hospital from cardiogenic pulmonary edema and circulatory failure (pulmonary wedge pressure > 30 mmHg) and 3 patients left the hospital in good health although they presented serious complications. One of them left the hospital with a temporary pacemaker, and 1 of the 2 others died after two months owing to myocardial infarction. The authors discuss in detail the clinical features of this condition and emphasize the need for urgent and appropriate therapy as well as the need for safe environmental conditions.