Botulism is a rare disease in young children; like in adults, it causes flaccid paralysis due to presynaptic blockade of the neuromuscular junction. Food poisoning following ingestion of a product containing preformed toxin, such as deli meats or homemade preserves, is suspected in a patient of an age to consume such products, especially when there is a geographic outbreak of poisoning, but it can also affect infants. Infant botulism, which occurs following intestinal colonization by Clostridium botulinum, is observed exclusively in children under one year of age. In the most severe cases, symptomatic treatment requires a prolonged period of ventilatory and nutritional support while awaiting spontaneous recovery—often complete—during which patients are at risk of complications from resuscitation. Early administration of antitoxin serum accelerates this recovery, which requires that the diagnosis be considered promptly at an age that is, at first glance, unusual. We present three recent case reports illustrating this disease and propose a practical protocol to facilitate diagnostic and therapeutic procedures for the intensivist. (R.A.)