Life-threatening, glycoside-induced cardiac rhythm disturbances are often seen following accidental digitalis intoxication in small children. Modern therapeutic management should take into consideration the pharmacokinetics as well as the mechanisms responsible for cardiac and extracardiac symptoms. Discussed are the possibilities of eliminating and inactivating the ingested glycosides, the indications and contraindications for administration of electrolytes, as well as the use of anti-arrhythmic drugs and pacing for cardiac arrhythmias. Special consideration should be given to close observation and instrumental monitoring; ideally these should be carried out in an intensive care unit. Unnecessary loss of time in the management of such cases should be avoided through proper organization of diagnostic and therapeutic activities.