Introduction: In the last years poisoning by aluminium phosphide (AlP) became a common method of suicide with high mortality rates. Aim of the work: The study aimed to evaluate the characters and outcome of acute aluminum phosphide intoxicated cases at Sohag university hospitals. Patients and methods: It is a cross sectional study conducted on acutely AlP intoxicated patients attended Sohag university hospitals including a retrospective part from January 2020 to December 2021(23 case) and a prospective part from January 2022 to June 2022 (41 case). Demographic data, mode of poisoning, route of administration, amount taken, delay time, vital signs, degree of coma, ejection fraction, troponin I and creatinine levels and first aid measures were recorded then related them to the patient outcome. Results: the incidence of ALP toxicity increased every year, in 2020 was 10.9%, in 2021 (25%), while, in the first half of 2022 it was 64.1%. The mean age was 21.7± 10.65 with male predominance by 53.1%. There was a significant increase in percentage of survived patients decontaminated by paraffin oil (84.6%) compared to other methods (15.4%). Receiver operating characteristic curve (ROC) was used to assess predictors of mortality in acute ALP-poisoned patients. The accuracy rate of ejection fraction, poisoning severity score (PSS), dose, serum troponin I, systolic blood pressure, delay time, and HCO3 were 100%, 97.7%, 94.4%, 93.7%, 89.5%, 81.9%, and 80.1% respectively with excellent discrimination. Diastolic blood pressure (77.9%) and PH (75.2%) with acceptable discrimination. While, creatinine and GCS gave non-acceptable discrimination. Conclusion: the frequency of suicidal ingestion of ALP is increasing every year. Decontamination by paraffin oil and early presentation had a better prognosis. At admission assessment of ejection fraction, PSS, serum troponin and creatinine, blood pressure, ABG have a beneficial role as predictors of mortality and emergency intervention to cases with probable bad prognosis.