Objective: Puffer fish consumption and as a consequence tetrodotoxin poisoning out of it is becoming an increasingly common incidence in Bangladesh. Due to availability and affordability in rural areas puffer fish ingestion is becoming an important cause of poisoning mainly in the coastal regions of the country. In this communication we report an event of tetrodotoxin poisoning in ten people in Bangladesh. Case report: Nine male and one female patients were admitted to Dhaka Medical College Hospital with a history of ingestion of puffer fish. Three of them were from same family; others are from same locality but not related. Presenting features were tingling sensation around mouth and lower limbs in 7 patients, heaviness of tongue in 5, weakness in walking in 6, vomiting in 9, blurring of vision in 2, double vision in 1, inability to talk, slurred speech and generalized weakness in 2, respiratory difficulty in 2 patients. Sensory symptoms were reported to appear earlier. Physical examination revealed reduced touch sensation in both upper and lower limbs and in face in 3 patients, dilated pupils slowly reacting to light in 5 patients. One patient presented with respiratory failure with muscle power 1/5, absent deep jerks and reflexes and died within 20 minutes of admission. Five other patients were treated with subcutaneous neostigmine. Remaining patients received symptomatic management. All nine patients improved and were discharged after one day. Patients were not available for follow up. Conclusion: Health personnel should be aware and have sufficient knowledge regarding the manifestations, complications and management of puffer fish poisoning. Common people should be made aware of the potential risk of eating puffer fish, proper preparation process, about the warning symptoms and signs of puffer fish poisoning, and when to seek medical help. [ABSTRACT FROM AUTHOR]