This study was conducted to identify predictors that might be useful for determination of prognosis for cases of acute theophylline toxicity. Thirty cases with acute theophylline toxicity were recruited and gave consent to participate in this study. Patients were subjected to full history taking, and their vital and clinical data were recorded. Serum theophylline levels and routine laboratory investigations were measured. The studied outcomes of the patients were recorded. A statistically significant association was found between each of the vital data (pulse, temperature, respiratory rate), neurological manifestations (tremors, agitations, hallucinations, seizures), serum theophylline level, and the arterial blood pH of the studied patients on one hand and each of the duration of hospital stay, the need for ICU admission, mechanical ventilation, and hemodialysis on the other hand. It could be concluded that, patients presenting with neurological manifestations are at higher risk for developing complications and may have a poor prognosis. Additionally, metabolic acidosis may affect the clinical course of acute theophylline toxicity and can alter the patient's outcome. Moreover, serum theophylline level can be taken as a predictor of outcome for cases of acute theophylline toxicity.