Aluminum phosphide (ALP) is a pesticide known for its high cellular toxicity, making it one of the common means of suicide in developing countries. We report the case of a 19-year-old female who presented to the emergency department after ALP poisoning. Initial emergency treatments were administered. Eight hours later, due to respiratory distress, she was intubated. Cardiac arrest occurred immediately after intubation, but successful resuscitation was performed. The patient subsequently developed acute respiratory distress syndrome. With proper ventilator adjustment on the third day, her hemodynamic status stabilized. A computed tomography (CT) scan taken after 72 hours showed improvement in lung opacities. The patient was successfully extubated, transferred to the general ward, and discharged following psychiatric counseling. Acute respiratory distress syndrome in the context of ALP poisoning represents a critical condition with a high mortality rate. Its primary differential diagnosis is pulmonary edema. Proper supportive care led to clinical improvement within six days of severe ALP poisoning.