Abstract Hyoscine butyl bromide, an anti-spasmodic is often used for alleviation of colicky abdominal pain. Few studies have shown its safety and efficacy in children. Apart from common side effects, acute psychosis has been rarely reported. With this case report, we would like to reflect a message that hyoscine butylbromide should be used carefully in children, along with the emphasis on the correct dose, frequency and competency of the practicing clinician.