A sensitive and selective method for simultaneous determination of 29 toxic alkaloids in human blood and 31 in urine using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry was developed and validated. The samples were diluted with 0.1 mol L -1 HCl, and the target alkaloids were purified by solid phase extraction. The separation of 31 alkaloids was carried out on a C18 column using a gradient mobile phase with 10 mmol L -1 ammonium formate in water with 0.1% formic acid and methanol at the rate of 0.25 mL min -1 . The triple-quadrupole mass spectrometer equipped with an electrospray source in the positive mode was set up in the dynamic multiple reactions monitoring mode (dynamic MRM) to detect the ion transitions of 31 alkaloids. The calibration curves were linear over a range of 0.5-400, 1-400, or 4-400 lg L -1 for target alkaloids in human blood and urine, and the correlation coefficients (r 2 ) was higher than 0.9943. The limit of determination and limit of quantification were 0.2-1 and 0.5-4 lg L -1 for blood and urine, respectively. The only exceptions were sanguinarine and chelerythrine in human blood. All the target alkaloids were stable under the test condition. In addition, the solvent effect and reconstituted solution were investigated. The method was validated and proved to be accurate and precise over the studied concentrations and suitable for poisoning diagnosis and forensic toxicology.