The epidemiology of paraquat (PQ) intoxications in Surinam was studied in the Akademisch Ziekenhuis Paramaribo, the University Hospital that manages 83% of all cases occurring throughout the country. For 1985 and 1986 the corrected incidence rates of PQ poisoning were 211 and 68 cases/million population/year. The former is the highest figure reported worldwide. Incidence was more pronounced in males than in females, and 30-39 years males had the most extreme age specific rate. Suicide attempts accounted for 76% of our cases. Hindustani, who have easier access to the product, were at higher risk than other ethnic groups. The overall case fatality rate (CFR) was 71%. It was significantly more unfavourable in males (79%) than in females (57%) and increased with age. CFR was not related to circumstance of poisoning or ethnicity. The monthly incidence of PQ poisoning depended on the volume of monthly PQ imports and the year under study. The latter may be explained by qualitative changes in the distribution system in 1986 when, for economic reasons, the product was only sparsely available to the general public. This observation lends strong support to the WHO recommendation to restrict supply of PQ concentrate to professional users.