Vomitoxin, also known as deoxynivalenol (DON), is the most commonly found trichothecene contaminant in foods and it is the most toxic mycotoxin that causes vomit and anorexia. DON is produced by Fusarium and toxic to organs and tissues such as the intestinal system, immune system, nervous system, liver, kidney and spleen of animals and humans, and has strong cytotoxicity. The intestine is the first barrier against its toxic effect. In this paper, DON pollution characteristics in foods, DON absorption and metabolism, and its intestinal toxicity in different models are reviewed. In view of the easy transformation of DON, the intestinal toxicity of its derivatives also is also summarized. We believe that this paper will provide a reference for toxicological research of DON and its derivatives in the future.