organophosphates are widely used in agriculture as pesticides, in industry as softening agents and additives to lubricants. They are also used as household chemicals, allowing many opportunities for acute poisoning, as well as for occupational use. Besides, organophosphates being nerve agents are used in military setting or in terrorist attacks. Organophosphates self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200 000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphates pesticides are available. Patients and methods: a comparative study in which iv magnesium sulphate was given in a dose of 1g/6 hrs for 24 hrs to 50 patients acutely intoxicated with organophosphate who are treated with atropine and oximes (group i) and compared to 50 patients who are not given iv magnesium sulphate who are treated with atropine and oximes then atropine use and oxime use in the two groups are compared. Results: comparison between the control and the group which took magnesium sulphate showed a statistical significant difference between the 2 groups in the atropine and the oxime use (p<0.05). Conclusion: magnesium sulphate decreases atropine and oxime use in acute organophosphate toxicity. Such information may in turn guide clinical practice to the use of magnesium sulphate in acute organophosphate toxicity and so more studies should be done to confirm these findings