Metoclopramide poisoning can precipitate acute extrapyramidal symptoms (EPS), typically occurring shortly after ingestion. Delayed recurrent dystonic reactions, however, are uncommon. This case illustrates an unusual presentation of oculogyric crisis occurring eighteen-hour post-ingestion. A healthy 3-year-9-month-old girl unintentionally ingested 170mg (12.7mg/kg) of metoclopramide tablets. Although she vomited soon after ingestion, she developed 30-minutes neurological symptoms: torticollis with blank stare of eyes, arched spine, and limb stiffness eighteen-hour later. She was haemodynamically stable with a Glasgow Coma Scale score of 15/15. Early diazepam resulted in transient symptoms resolution; However, recurred occurred during transfer, necessitating procyclidine administered. Consultations with paediatric neurology , clinical toxicologist, and the national poison centre were made. Benzhexol was initiated for symptoms control. Laboratory investigations, including urine toxicology , were unremarkable. Safeguarding assessment exclude non-accidental injury . Shewas admitted for 48-hour observation with no recurrence and discharged without neurological sequelae. EPS requires a systemic and timely approach. First-line therapy for acute dystonic reactions typically result in rapid symptom resolution, if unavailable, second-line therapies should be considered. Early consultation with emergency physician, paediatrician, clinicaltoxicologist and national poison control centers are invaluable with information including: substance’s pharmacodynamics and pharmacokinetics, long-term sequelae, antidotes or supportive management-guides clinical decision-making. Important to consider brainimaging to rule out intracranial pathology , whereas electroencephalography to verify normal cortical activity . Delayed EPS following metoclopramide poisoning can be potentially lifethreatening in children. Early recognition, multidisciplinary collaboration, and supportivemanagement can result in full recovery . Caregiver education and early medical attention remain critical to reducing poisoning incidents.