Acute poisoning represents one of the most common medical emergencies in childhood; Children are uniquely vulnerable to uptake and adverse effects of pesticides because of developmental, dietary, and physiologic factors. This study was designed to describe the pattern of childhood poisoning with pesticides in order to take up appropriate planning and prevention techniques. This retrospective study included 280 pediatric cases under the age of 18 years with acute pesticide poisoning admitted to National Center for Environmental & Clinical Toxicological Research (NECTR), Cairo University Hospitals during the period from January to December 2014. Complete demographic and clinical data were recorded and analyzed. Results revealed that, Incidence was more common among Females than males (65.4 % versus 34.6%). Majority of cases were in adolescent age group (12-18yrs) and constituted (63.2%). Suicidal attempts accounted for the highest percent (52.5%) of poisoning. The presenting symptoms were muscarinic manifestations in (51.4%). Recovered and discharged cases accounted for (88.9%), (7.2%) left against medical advice, (2.9%) complicated and referred to the suitable specialty, (1.1%) complicated and died. The period of hospitalization was less than 24 hrs in the majority of cases (78.9%) compared to (18.9%) were hospitalized more than 24 hrs. Effective health promotion programs for parents and caregivers regarding poisoning hazards are needed to increase awareness and reduce the incidence of poisoning among children.