**1. Introduction**

Poisoning is one of the leading causes of mortality and morbidity in many countries. In 1955, poisoning was the most common cause of death in patients aged between 35 and 44 years [1]. Tramadol was first manufactured in Germany in 1970 to relieve post-surgical and chronic pains [2]. It is currently the most commonly prescribed opioid in the world [3]. According to the Australian studies, tramadol use has increased almost 10 times between 1998 and 2004 [4].

Although tramadol is very commonly prescribed, it should be administered with the consid‐ eration of the risk to benefit ratio [5]. Tramadol is one of the most common causes of poisoning in adult male patients with the previous history of drug addiction and psychological problems and suicide is the most common motivation for its use in this group of the patients [1,3,6-8]. The aim of this review is to evaluate all possible clinical manifestations and life-threatening signs/symptoms of tramadol poisoning.
