The Maryland Office of the Chief Medical Examiner investigate four child fatalities that occurred during 1992-96. Three cases occurred within a 3-month period. Two victims accidentally ingested methadone within 3 days of each other. Three children found and drank methadone that was in a container or in fruit juice in a container on a table or in a refrigerator. In addition, a 4-month-old baby died as a result of methadone given by his grandmother because he was sick and irritated; the grandmother’s doctor had prescribed methadone for her back pain. These cases reinforce the need for proper education of not only the addict but also other household members about the dangers of methadone. Individuals providing this education should include methadone treatment program counselors and medical staff, including pediatricians, who treat children of addicts on methadone programs. These actions should help reduce childhood methadone poisonings significantly. Tables and 15 references (Author abstract modified)