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Acquired Methemoglobinemia - A Sporadic Holi Disaster. OBJECTIVE: To study clinical profile and outcome in patients with methemoglobinemia following exposure to toxic colors during Holi festival. METHODS: This retrospective study included 112 children (5 to 12 years) admitted with methemoglobinemia after playing Holi. Clinical and treatment details were reviewed. RESULTS: The common symptoms were giddiness, vomiting and headache. Treatment included thorough skin wash, intravenous fluid and methylene blue in 111 children. Age 7-9 and > 11 years, vomiting, giddiness, cyanosis, PaO2 < 80 mm Hg and oxygen saturation < 95% were associated with higher need for methylene blue. All children had a good outcome. CONCLUSION: Timely diagnosis and management of acquired methemoglobinemia can save lives.