Background: The current study was carried out to study the effect of severe acute organophosphate compounds (OP) toxicity on the pancreatic profile in adults. Subjects and Methods: Six ml of venous blood were drawn from 260 patients (18-52 years) with severe acute  OP toxicity who were admitted to the intensive care unit of Minia Poisoning Control Centre (PCC) during the period from May the 1^st, 2012 to April, the 30^th, 2014, and also from 20 healthy adults of the same age group acting as control. Blood samples were analyzed for: Pseudocholinestrase (PChE), serum insulin, serum α-amylase and serum lipase. Results: PChE level in intoxicated patients on the day of admission was highly significant decreased when compared with control. There was highly significant increase in the serum levels of amylase and lipase in intoxicated patients as compared to normal control group. In addition, there was highly significant increase in blood glucose level in intoxicated patients as compared with control group while there was no significant effect on the serum insulin level. A significant correlation was found between the degree of PChE inhibition and the elevation of serum amylase, lipase and serum glucose level. Conclusion: acute pancreatitis was evident in severe cases of OP intoxication on the day of admission, also OP -induced hyperglycemia is evident and most probably due to other cause rather than hypoinsulinemia.