Acute Poisoning is the third leading cause of injury-related hospitalization during pregnancy after traffic accidents and falls. managing a pregnant patient involves managing two patients at once, the mother and the fetus. The aim of this review is to highlight the challenge facing health care providers during management of poisoned pregnant since this dual management paradigm is often seen as a complex balancing act, benefits to the mother against risks to the fetus and vice versa. Added to this the relative lack of literature to support or refuse any given treatment recommendation. The higher acuity of the critically ill patient brings this situation to its sharpest point as the death of mother, fetus, or both becomes an ever more likely possibility. This review discusses the mode of exposure and how it affects the outcome of poisoning during pregnancy, the physiological changes during pregnancy that alter the toxins response and effects, the general management measures, decontamination, antidotal therapy and specific considerations and recommendations in cases of most common intentional or unintentional toxic exposure during pregnancy. Conclusion: poisoning in pregnancy can occur in several ways, including suicide attempt, and accidental exposures and the best approach to all poisoned pregnant patients is to treat the mother in the same way as if she were not pregnant. Improved maternal survival will typically lead to improved fetal survival