In the summer of 1998, the so-called Wakayama currty poisoning case occurred, and subsequently additional murders took place in which the accusred used sodium aziede and thallium to posison their victims. When the poison victims were admitted to hospital, food poisoning was mistakenly diagnosed. Due to serious concerns that such misdiagnoses might recur, the Japanese Ministry of Health and Welfare equipped 10 level-1 trauma and critical care centers and 66 critical care centers nationwide with high-performance liquid chromotographs, ion chromatographs, gas chromatographs, fluorescence X-ray analyzers, and high-frequency plasma mass spectrometers. This equipment will allow the detection of most types of industial and other chemicals as well as most therapeutic drugs. This report describes the current status of poison analysis systems and the role of level-1 trauma and critical care centers in cases of poisoning.