BACKGROUND: Methanol is an extremely toxic compound. Severe metabolic acidosis, intense neurological and visual affection are the hallmark of toxicity. Despite maximal supportive care, mortality rate is yet high. OBJECTIVES: This study aimed to determine the predictors of poor outcome in acute methanol poisoning. METHODS: In this retrospective study, forty acute methanol poisoned patients were recruited. Data of four years (2017 to 2020) was obtained from Tanta university Poison Control Center (TUPCC) archive. Data of patients' outcomes were recorded in addition to demographic data, clinical examination and laboratory investigations results. RESULTS: Out of the 40 enrolled patients, 17 patients had poor outcome either death or visual affection and the remaining 23 patients had completely recovered. A significantly prolonged time elapsed between methanol ingestion and admission in poor outcome group compared to good outcome one. Likely, the mean GCS, arterial pH andHCO3 levels were significantly lower in poor outcome group. Additionally, significant increase in total leucocytic count, RBS, ALT, AST, serum creatinine, blood urea, PT and anion gap was noticed in poor outcome group. CONCLUSIONS: Our study shows that, delayed hospital admission and on admission GCS were identified as potential predictive factors of poor outcome in acute methanol poisoning.