Background: Methanol is a toxic alcohol found in illegal liquor, and its poisoning may cause death if not treated timely and properly. In 2018, Methanol toxicity in Iran increased dramatically. Regarding the high prevalence of Methanol toxicity, its high mortality rate, and the cost of treatment as well as the importance of timely diagnosis in the treatment of this condition, we decided to review Methanol toxicity, its signs, symptoms, diagnosis, and treatment. Evidence Acquisition: We searched for articles on reliable databases such as Embase and Medline from January 2018 to May 2018 using the following keywords: “ Methanol, ” “ toxic alcohol, ” and “ ethanol toxicity treatment. ” Results: This review discusses how to diagnose Methanol toxicity by using clinical signs and symptoms and laboratory examinations; it also suggests new treatments. Meanwhile, we provide alternatives for diagnosis in case of shortages of tests in the emergency department. Conclusion: Diagnosis of ethanol toxicity due to non-specific signs and symptoms, late patient’ s referral, and lack of proper history-taking can be very difficult and delay the onset of treatment. There is also no clear scientific evidence as to whether ethanol or fomepizole should be used as the first choice of therapy for Methanol toxicity because there is no direct comparison between these two antidotes regarding their effectiveness and safety. The appropriate antidote is chosen depending on the availability, cost, accessibility of hemodialysis, and the physician’ s experience. If the therapist does not have enough experience, it is easier to use fomepizole.