Background: Acute pesticide poisoning has become major public health problem world-wide. Farmer suicide is burning issue in many states of India. Organophosphate causes most self-poisoning deaths in southern & central India. The aim was to study incidence, clinical and social profile, risk factors, and factors modifying outcome . Methods: A hospital based cross-sectional study was carried out at government rural tertiary health care centre. This study comprises cases of acute pesticide poisoning of age more than 12 years admitted in intensive care unit of this institute during study period from January 2012 to June 2013. Results: Incidence of acute pesticide poisoning was 0.36% of total hospital admissions. Pesticide poisoning was more common in males (74.26%) than females (25.73%) with M: F ratio of 2.9:1.82. 35% were suicidal cases followed by accidental cases 13.97% and only 3.67 were homicidal. Incidence of suicidal and accidental poisoning was more common in married population (75.73%). History of social and domestic problems (50.80%), alcohol abuse (13.39%) and marital friction (11.60%) were common risk factors. Ingestion route of poisoning was most common (71.73%). Excessive salivation was the most common symptom observed in 72.05%. Conclusions: Mortality in case of organophosphorus poisoning depends on amount to which person exposed, type of compound, time lapse between exposure and initiation of treatment, the general health of the patient and facilities available for advanced supportive care.