Background and aims: Intensive care management of Organophosphate (OPC) poisoning includes decontamination, resuscitation, supporting respiration if necessary, rapid administration of atropine and Oximes. Although WHO recommends use of Pralidoxime, controversy surrounds the role of oximes and its effectiveness remains unclear. Aims: 1) To describe the clinical profile of children admitted to PICU with organophosphorus poisoning. 2) To analyze the duration of ventilatory support, incidence of Intermediate syndrome and mortality rate among these children. Methods: A retrospective observational study by reviewing the charts of children admitted with OPC poisoning in our PICU during the period October 2008 to September 2012. Results: 35 children aged between 9 months and 15 years were admitted with pesticide poisoning. 30 children consumed organophosphates, 3 consumed carbamates and 2 organochlorides. Male predominance (22, 64%) was noted. Eight (20%) were intentional. Twenty children (54%) received primary care before reaching the tertiary centre.Most (73%) of patients stayed below 3 days in ICU with a range of 1 to 27 days. All, except the two who had consumed organochlorides, received atropine infusion. Serum pseudocholinesterase was less than 20% in 15 patients (35%), 20–50% in six and eight had more than 50%. Eighteen patients (51%) needed ventilatory support. Majority of them (66%) were ventilated for less than 3 days.Only two (5%) developed IMS. Two children required readmission for stridor and recurrence of symptoms respectively. Among the 35, only one left against medical advice because of suspected brain death (mortality rate 3%). Conclusions: Even though oximes are not used, mortality and incidence of IMS was found to be low because of aggressive resuscitation and supportive therapy.