Introduction: Pesticides and insecticides are easily accessible in India as a predominantly agrarian population reside. This has resulted in unregulated selling of these compounds and is often the cause of poisoning due to accidental, suicidal or homicidal motive. Though commonly ingested, people do find innovative ways to administer these compounds. Such instances are scarcely described in medical literature let alone the prescribed management. Case Report: We present a case of suicidal parenteral injection of pyrethroid ester insecticide (Deltamethrin) into left upper limb. Initially the patient and relatives tried to masquerade it as a case of an insect bite but the clinical features painted a suspicious picture. Conclusion: This rare case account is the first description of parenteral deltamethrin poisoning and portrays the management of such a patient and reviews literature pertaining to parenteral pesticide poisoning. Our case management yielded successful salvage of the involved limb with fasciotomy, multiple debridement and NPWT followed by skin grafting with a considerable lengthy hospitalization for the patient and laborious treatment on the part of treating physicians.

Keywords: Parenteral poisoning; Injection; Pyrethroids; Deltamethrin; Organophosphates; NPWT; Limb salvage; Upper limb.