Carbofuran is commonly used as in agricultural practices worldwide causing harmful effects on health. Here, we report a Tunisian case of Carbofuran intoxication complicated by septic shock and acute cardiogenic pulmonary edema which, to the best of our knowledge, have not been previously reported.A 23-year-old female patient was admitted to the Emergency Department for an altered state of consciousness. The chronological account began on the day of admission, following the ingestion of black powder, estimated at 10 g, in an apparent act of suicide. Due to neurological disorders, the patient was sedated with a benzodiazepine and received mechanical ventilation and was subsequently transferred to the Intensive Care Unit (ICU) for further management. The levels of pseudocholinesterase demonstrated a pronounced decrement, measuring 828 IU/L. The control of troponin yielded a value of 25.3 ng/ml, while ProBNP was 1929 pg/ml. Additionally, the concentration of procalcitonin amounted to 21.27 ng/ml. Upon admission, a transthoracic echocardiogram (TTE) was performed revealing an elevation in filling pressures, and an enlarged inferior vena cava with reduced compliance. After weaning from mechanical ventilation, a follow-up ultrasound examination was carried out on the eighth day, demonstrating a normalized left ventricular ejection fraction (LVEF) of 55% without accompanying elevation in filling pressures.Based on the patient's clinical presentation, physical assessment, and laboratory findings, the diagnosis encompassed toxic coma complicated by septic shock, aspiration pneumonia, and acute cardiogenic pulmonary edema. Our case showed a heart failure secondary to carbofuran intoxication. Toxic shock can have several haemodynamic profiles depending on the xenobiotic involved, with a cardiovascular tropism whose mechanism is not always well elucidated.