Background: kerosene is a common cause of childhood poisoning specially in low and middleincome countries. Complications are primarily related to pulmonary aspiration which is a significant contributor to Intensive Care Unit (ICU) admission. Objectives: To study the clinical profile of kerosene poisoning in children presented to Menoufia Poison Control Centre and to identify patients who need ICU admission. Methods: a prospective study including children presented to Menoufia Poison Control Center with acute kerosene poisoning during the period of three years from 2018 to 2020. Results: During the study period, a total number of 154 children were admitted. Male children were 56.5% and females represent 43.5%. More than half of cases (52.6%) were less than 3 years. The majority of cases were from rural areas (76.6%). All cases were exposed to kerosene orally and 24.9% had combined oral and dermal exposure. ICU admitted cases had longer period of hospitalization and presented mainly by tachypnea, hypoxemia and chest retractions. Conclusion: Respiratory system is mainly affected in kerosene poisoning. Patients presenting with respiratory distress, moderate or severe grades of PSS, hypoxemia on presentation should be admitted to the ICU. Community education is necessary to reduce this preventable poisoning in children.