Objective: We aimed to determine the factors that can be used to predict hemodialysis treatment in lithium poisoning.Material and Methods: The data of 111 patients diagnosed with lithium poisoning who applied to the emergency department between January 01, 2010 and December 31, 2020 were analyzed retrospectively. Sociodemographic characteristics of the patients, vital signs, Glasgow Coma Scale score at the time of admission, laboratory results, purpose of using lithium-containing drug, other drugs, nausea, vomiting, lithium-related neurologic symptoms, diarrhea, type of treatment and length of hospital stay were recorded in the patient study form. Risk factors for hemodialysis treatment were analyzed using a univariate and multivariate logistic regression model.Results: The most common symptom in patients with lithium poisoning was fatigue (81.1%), and the most common neurological symptom was tremor (73%). It was determined that 22 patients received hemodialysis. All of the patients receiving hemodialysis treatment had at least one neurological symptom. The mean serum lithium level of the 111 patients included in the study was 2.24±0.88 mmol/L, and the highest serum lithium level measured was 6.30 mmol/L. When the treatments applied were compared in terms of the causes of lithium intake, a statistically significant difference was found (p=0.006). Most of the patients who received hemodialysis treatment (n=17; 77.3%) consisted of patients who took high-dose medication over the recommended lithium treatment dose.Conclusion: Newly developed ECG changes and regression in GCS scores were found to be predictive factors of extracorporeal therapy in the treatment of lithium poisoning, which is rare among poisoning cases admitted to the emergency department. In the management of lithium intoxication, the use of extracorporeal therapy should be considered, even if there is no severe serum level elevation at the time of admission, especially in patients with ECG changes, changes in consciousness and neurological changes.