Background Nationally and internationally a discussion is ongoing on the effectiveness, the dose required and the treatment duration of N-acetylcysteine to treat acute paracetamol intoxication. Objective In this paper we present the results of a national survey among hospital pharmacists. In this research the present treatment duration and dosing of N-acetylcysteine is reviewed. Design and methods An electronic survey consisting of 15 questions on the treatment of acute paracetamol intoxications in hospitals has been sent to hospital pharmacists. Results Hospital pharmacists of 67 of the 69 Dutch hospitals (97%) have responded. The majority (52 centres, 78%) indicated to treat acute paracetamol intoxications according to the treatment guideline of the NVZA/NVKFB on toxicologie.org. 64 centres (96%) used the dosing regimen of the above-mentioned treatment guideline, namely 150 mg/kg in 1 hour, followed by 450 mg/kg in 24 hours. The toxicologie.org treatment guideline of 150 mg/L at 4 hours after intake, (or 75 mg/L at 4 hours after intake for sensitive patients) to start N-acetylcysteine therapy, is used by 61 centres (91%). 30% of the centres indicate that there are differences in the treatment of an acute paracetamol intoxication in children and adults. In general, in these centres, it is preferred to start early with N-acetylcysteine in children. Conclusion Despite local differences, in the majority of the hospitals acute paracetamol intoxications are treated according to the toxicologie.org treatment guideline. Because of this, toxicologie.org is an appropriate medium to implement possible future adaptations in the N-acetylcysteine dosing regime in Dutch hospitals.