The southern ground hornbill (Bucorvus leadbeateri) has been classified as globally vulnerable and, in South Africa, regionally endangered, with a negative population trend. Factors contributing to the population decline in South Africa are poisoning, electrocution, and illegal capture for trade, coupled with slow reproductive rates and extensive habitat requirements. Lead toxicosis is a previously undescribed threat for the population. An adult southern ground hornbill presented with acute lead toxicosis due to lead particles in the gizzard, which required intensive treatment. Two other hornbills were likely exposed. The source of the lead in these cases was likely a carcass of a porcupine that was killed with lead shot. This report highlights the importance of the use of lead-free ammunition within the habitat of the southern ground hornbill in South Africa.