Background: Self-poisoning, a method often chosen for near-fatal suicide attempts, substantially increases the risk of eventual suicide and necessitates hospitalization due to chemical-induced health impairment. However, there is a dearth of studies investigating the choice of self-poisoning in near-fatal suicide attempts and the cognizance of potential non-lethal risks. Objective: The present study aims to explore the factors contributing to the decision to self-poison in near-fatal suicide attempts as well as the awareness of its potential dangers among survivors. Methods: An exploratory qualitative study was conducted with 17 adult psychiatric patients who survived near-fatal suicide attempts by self-poisoning. These patients were admitted to a general hospital in São Paulo, Brazil. Results: Participants indicated three primary factors influencing their choice of self-poisoning: the anticipation of a painless death, belief in its efficacy as a suicide method, and accessibility of chemical agents. None of the participants had contemplated the health risks associated with survival following a self-poisoning attempt, indicating a significant role for impulsivity and misinformation. Conclusion: The majority of the participants selected self-poisoning with the expectation of a painless death. Even though half of the sample necessitated hospitalization post-attempt, none had contemplated the potential risks associated with surviving the ingestion of chemical agents. As a result, our findings suggest that prevention strategies must include educating at-risk individuals about the potential health damages associated with the use of chemical agents in suicide attempts.