Background: Methanol is a colorless and poisonous liquid that is commonly used as an industrial and household solvent. Methanol poisoning is a rare but extremely hazardous form of in toxication that affects the central nervous system and causes visual disorder, drowsiness, seizures and coma.

 Case Presentation: A 29-years-old man with methanol intoxication presented with drowsiness and acidosis with subsequent brain hemorrhage requiring prolong mechanical ventilation resulted in persistent visual impairment and disequilibrium.

 Conclusion: Prolonged mechanical ventilation in patients with methanol intoxication may be assouated with irreversible brain damage.