Background: Aluminum phosphide (AlP) is a type of fumigant which became a leading factor for suicidal poisoning in developing countries. In the absence of specific antidote, acute aluminum phosphide poisoning is considered a major public health problem. Determination of prognosis is a major concern for clinical toxicologists. Prognostic factors facilitate appropriate disposition to limited intensive care unit (ICU) beds. Aim: The aim of this study was to determine the impact of clinical and laboratory findings for prediction of need for intensive care unit admission in acute aluminum phosphide poisoning. Patients and methods: This cross sectional study was conducted on 114 acute aluminum phosphide poisoned patients admitted to Tanta University Poison Control Center (TUPCC) from May 2017 to November 2019. For these patients characteristic clinical manifestations, laboratory investigations and outcome were recorded. Results: Acute aluminum phosphide poisoned patients who required ICU admission represented 69.3% of cases and 91.1% of all cases died. A significant difference was recorded between patients who needed and those who didn't need ICU admission as regard Glasgow Coma Scale (GCS), pulse, random blood sugar, pH, HCO3 and serum potassium. Moreover, respiratory rate, oxygen saturation, systolic blood pressure and serum Na were found to be good predictors for ICU admission need in acute aluminum phosphide poisoned patients. Conclusion: Respiratory rate, oxygen saturation, systolic blood pressure and serum Na can predict need for ICU admission in acute aluminum phosphide poisoned patients.