Being a colorless, odorless, non-irritating gas, carbon monoxide (CO) can be a silent killer in case of closed space fire outbreaks and in cases of other accidental exposure due to incomplete combustion of hydrocarbons. During exposure to CO, CO binds to hemoglobin, replacing oxygen due to its higher affinity for heme-containing compounds in comparison to oxygen. Thus, CO blocks the mitochondrial respiration and generation of ATP, ultimately affecting all organ systems. A high level of suspicion is the cornerstone of management to prevent complications and improve outcomes. In fact, a delay in starting management will increase the chance of acute and delayed neurological sequelae. Providing oxygen in highest possible concentration is the main stay of therapy in CO poisoning. Exposure to CO is suspected by clinical history and suggestive symptoms and measurement of carboxyhemoglobin(COHb) level by co-oximetry at the site of incident. Oxygen replaces CO from the heme binding site in a competitive way, and the half-life of COHb depends on the concentration of oxygen provided. Hyperbaric oxygen therapy (HBOT) has got role in the management of CO poisoning due to its ability to increase the amount of dissolved oxygen, though routine recommendation of HBOT in CO poisoning is yet to come.