Anhydrous ammonia is a relatively common cause of chemical injuries. Most injuries are the result of accidental exposure, frequently in the course of work. Exposure to anhydrous ammonia may produce serious injury to the eyes, respiratory system, and integument. Anhydrous ammonia injuries occurring in a predominantly agricultural region are reviewed. The pathophysiology of anhydrous ammonia injury is reviewed. Therapeutic modalities are described. Guidelines to prevent or minimize injury are delineated.