A 60-year-old woman suffering from rheumatoid arthritis and taking methotrexate was admitted with recurrent episodes of nausea, vomiting, constipation, loss of appetite, myalgia and backache, sternal chest pain, costal and jaw pain. On examination the epigastrium was tender to palpation and non-rigid. Laboratory tests showed normocytic anaemia (with a haemoglobin concentration of 8.6 g/dl), elevated blood urea and creatinine levels, hyponatraemia, hypochloraemia, haemolysis and polychromasia, anisocytosis, poikilocytosis and basophilic stippling of several red cells. On gastroscopy an ulcer was excluded, ultrasound scan of abdomen, X-ray of chest and pelvis showed no abnormalities. The electrocardiogram showed a right bundle branch block and left anterior hemiblock. In the differential diagnosis of anaemia with basophilic stippling and abdominal discomfort, lead poisoning was considered. Whole-blood lead concentration was markedly raised to 852 μg/l (normal < 100 μg/l). Lead poisoning was the result of the use of Ayurvedic drugs during a period of 7.5 months prior to admission to the authors’ hospital.