Toluene is a solvent often used in paints and industrial cleaning. In closed spaces, inhaling its fumes can quickly cause brain and metabolic problems.An 18-year-old worker was found unconscious in a painted tanker after breathing toluene fumes. He had acid–base disturbance  but improved with oxygen, fluids, and monitoring. He recovered fully without complicationsThis case shows an uncommon combination of acid–base disorders after acute toluene exposure. Few reports describe such full recovery after prolonged exposureEvery minute counts in toluene exposure. Awareness and prevention can turn a deadly risk into a story of full recoveryAn 18-year-old male smoker with no significant past medical history was brought to the ED with altered mental status following a workplace accident. He had been working inside a newly painted tanker truck and was found unconscious at the scene. His last recollection was at approximately 10am., and he was discovered the following day at around 6:00 a.m., indicating a period of unconsciousness of 16 hours. Evidence of urinary incontinence was noted. On initial examination he was alert but euphoric (GCS 15/15), with normal neurological findings. His SBP was 120 mmHg DBP was 80 mmHg, heart rate was 85 bpm, and SpO₂ was 100% on AA.Serial arterial blood gas (ABG) analyses demonstrated progressive metabolic derangement. The initial ABG showed metabolic acidosis with partial respiratory compensation (pH 7.35, HCO₃⁻ 11.5 mmol/L, lactate 5 mmol/L). A subsequent ABG revealed a mixed picture characterized by respiratory alkalosis superimposed on a high–anion gap metabolic acidosis (pH 7.48, PaCO₂ 13 mmHg, HCO₃⁻ 9.7 mmol/L). A third measurement confirmed persistent alkalemia (pH 7.47) despite further bicarbonate depletion (HCO₃⁻ 8 mmol/L), indicating ongoing metabolic acidosis with sustained respiratory alkalosis. The rest of the laboratory findings were within normal range. A brain CT was performed and freaked no abnormalitiesThe patient was admitted to the ICU a for close monitoring and supportive management  and was discharged the following day with favorable outcomeEarly recognition, prompt correction of metabolic imbalance, and close monitoring are critical  especially  in cases of prolonged exposure and initial loss of consciousness.