Farmworkers in agricultural settings may encounter various toxic gases from exposure to fertilizers such as anhydrous ammonia; equipment with internal combustion engines, leading to carbon monoxide exposure; manure storage tanks that produce hydrogen sulfide; pest control fumigants such as metal phosphides, phosphine gas, 1,3-dichloropropene, chloropicrin, and methyl isothiocyanate; and silage in grain silos that produce nitrogen dioxide. Toxic gases can lead to serious morbidity and mortality. Early recognition of exposure and safety of healthcare personnel and other agricultural workers is paramount. Removal from toxic gas sources, decontamination, and supportive care are essential elements of initial care to stabilize the patient. Identification of the need for specialty care and transfer for treatment may improve survival.