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Objective This study applied a socio-material practice lens to examine health professionals’ responses to methanol poisoning in Bangladesh and to compare these practices with established guidelines.Design This study employed a rapid ethnographic design.Setting Data were generated in primary-level, secondary-level and tertiary-level health facilities in six districts of western Bangladesh between September 2024 and May 2025.Participants We carried out semi-structured interviews with 50 health professionals with responsibilities for managing patients experiencing alcohol-related or poisoning-related conditions.Results Among health professionals, the meanings of methanol poisoning as a diagnostic category, its symptoms and treatments are obscured by moral concerns about alcohol. Materials, including antidotes, for managing methanol poisoning were scarce, and health professionals reported using readily available medical supplies for supportive treatment, though not specifically adapted for methanol poisoning. Health professionals’ care practices for responding to methanol poisoning were often structured by these meanings and materials, with guidelines remaining largely invisible.Conclusions Socio-material practices of health professionals in response to methanol poisoning in Bangladesh are characterised by missed opportunities. Improving responses requires shifting the meanings of methanol poisoning as a diagnostic category, ensuring that materials such as treatment guidelines and appropriate antidotes, such as ethanol and fomepizole, are available and supporting providers to enact care practices that reflect these guidelines.