Aim and background: To study the clinical presentation in two cases of poisoning presenting with methemoglobinemia. To review common causes of methemoglobinemia and study differences in their presentation and management. Methemoglobinemia is a common presenting feature among patients presenting to the hospital following deliberate ingestion of various poisons. Case description: We report two patients who had consumed two different groups of toxins and presented with the common manifestation of methemoglobinemia. The first case involves indoxacarb ingestion, whereas the second case presents with consumption of organic fertilizer. Although presenting features and initial management were similar in both patients, the response to therapy, complications, and time to recovery were quite different. Conclusion and clinical significance: In rural backgrounds, suicidal attempts with chemical compounds used for agriculture are common. These compounds are numerous, and it is difficult to have knowledge regarding all of their presentations. Methemoglobinemia is one such presentation, which can easily be missed without a high degree of clinical suspicion. A thorough knowledge of all the toxins capable of causing methemoglobinemia and their unique features is necessary for the appropriate management of these cases.