Chemically, sulfur mustard (SM) is bis (2-chloroethyl) sulfide and is well known as mustard gas. There are various mustard agents. However, SM is one of the most important blistering or vesicating agents. SM forms sulfonium ion in the body and alkylates DNA leading to DNA strand breaks and cell death. Due to the high electrophilic property of the sulfonium ion, SM binds to a variety of cellular macromolecules. The most common complications of SM occur in lung, skin, and eye, which are the principal target organs due to its direct effect. The systemic toxicity leads to several manifestations. The first clinical manifestations of SM poisoning in victims occur in the eyes with a sensation of grittiness, lacrimation, photophobia, blepharospasm, and corneal ulceration. If exposure to vapor is prolonged, rhinorhea, laryngitis, bronchitis, necrosis of mucous membranes of the respiratory tract, and bronchopneumonia will occur. Skin lesions include erythema, blisters, and necrosis. The current treatment strategy consists of symptomatic management that prevents infections and promotes healing. There are no standardized or optimized methods of casualty management to reduce the suffering and provide speedy wound healing. At present, no antidote exists for SM poisoning. The best method of minimizing the injury is by immediate decontamination of the exposed individuals, followed by palliative treatment of symptoms. © 2009 Elsevier Inc. All rights reserved.