Background: Unintentional toxicology represented an important health problem in pediatrics. However, there was no appropriate map helping in design of proper preventive strategies. Objective: Investigating the pattern of acute toxicity of children aged 1–18 years in Damietta governorate. Subjects and methods: The study included children presented to Emergency Department of Damietta Poison Control Center (PCC) during the period from January 2015 to December 2015. In all children, the following parameters were studied: mean age, sex, residence, occupation, route of exposure, manner of poisoning, time elapsed between exposure to toxin and hospital arrival, past medical history, family history, seasonal distribution, admission place (ED, inpatient, ICU, or referral); and outcome (Improvement, referral and death). Clinical and Investigational aspect of the study included general examination, systemic examination and investigations (laboratory, ECG, Plain chest X-ray, Plain abdominal X-ray, CT and/or MRI in cases of coma or unexplained etiology). Curative aspect of the study included emergency measures, decontamination, enhancement of elimination, and administration of specific therapy). Results: There was a statistically significant difference between studied groups as regard gender distribution. Residence was rural in 78.4% and urban in 21.6%. The most common toxic agent(s) were insecticides (46.6%), hydrocarbons (24.1%), corrosives (19.8%) and medicinal agents (9.5%).  The toxicity was mild in majority of children (72.4%), and the severity of toxicity increased with increasing age. The delay time was less than an hour in the majority of children (58.6%). The oral route was the most common (69.0%) and oral route intoxication increased with increasing age.  Intoxication was accidental in the majority of studied children (84.5%) and no suicidal cases below the age of 6 years. Location of toxicity in studied children was home in the majority of subjects (84.5%) and outside home (15.5%), with a statistically significant difference between them. Outcome revealed that 30.2% and 69.8% were discharged from Emergency Department. The discharge rate from Emergency Department decreased with increasing age. Conclusion: The present study provided a road map for the pattern of childhood toxicity in Dameitta governorate. It is the first step to explore the magnitude of the problem in this area of Egypt. Future efforts are needed to complete the map with development of effective preventive strategies.