In the laboratory, this compound may be prepared by treating sodium cyanide with acetone, followed by acidification:[3] Considering the high toxicity of acetone cyanohydrin, a lab scale production has been developed using a microreactor-scale flow chemistry[4] to avoid needing to manufacture and store large quantities of the reagent.

[6] Treatment with sulfuric acid gives the sulfate ester of the methacrylamide,[clarification needed] methanolysis of which gives ammonium bisulfate and methyl methacrylate.

Crushing the tubers releases these compounds and produces acetone cyanohydrin.

Acetone cyanohydrin is classified as an extremely hazardous substance in the US Emergency Planning and Community Right-to-Know Act and carries an RCRA P069 waste code.

The principal hazards of acetone cyanohydrin arise from its ready decomposition on contact with water, which releases highly toxic hydrogen cyanide.