Fumigation involves releasing a pesticide either as a gas or as a substance that volatilizes into a gas in a treatment area. Fumigants can reach and affect pests that are inaccessible to other types of treatment and often do not leave harmful residues behind, which makes fumigation a useful tool for pest control. However, fumigants can easily penetrate materials and move beyond the application site, which increases the chance of harm to nearby workers or bystanders. There are different uses of fumigation, including structural, soil, burrow, and commodity fumigation. Several registered pesticide products can be used as fumigants, with active ingredients including methyl bromide, chloropicrin, sulfuryl fluoride, phosphine, 1,3-dichloropropene (1,3-D), methyl isothiocyanate (MITC), and dimethyl disulfide. Most human fumigation exposure is via inhalation of fumigant gases, which may also contact the skin and eyes. Not all fumigants have noticeable odors, especially at lower concentrations; therefore, harmful exposures may occur without warning, most commonly affecting the respiratory and neurological systems. The first signs of exposure are often irritated eyes, nose, and throat, followed by more severe respiratory effects, such as cough, bronchospasms, trouble breathing, pulmonary edema, and potentially death. Neurotoxic effects from some fumigants, such as methyl bromide, sulfuryl fluoride, and phosphine, include headache, ataxia, or seizures. Some fumigants affect the cardiovascular system, causing arrhythmias or tachycardia. Management of fumigant exposure and poisoning generally involves supportive care and symptom management, with no specific antidotes for chemicals currently registered in the United States as pesticide fumigants. Treatment may include the administration of oxygen with possible intubation and ventilation in severe cases, as well as seizure control for certain exposures. Depending on the chemical involved as well as the amount the patient is exposed to, some symptoms may develop or worsen hours or even days after exposure. Many patients who are occupationally exposed to fumigants are also exposed to other chemical hazards, so providers should take a comprehensive approach to health history questionnaires to capture the full extent of their patients’ chemical exposure.