Background: Poisoning with substances that have cardiotoxic effects has become the major cause of early deaths globally. These substances include several compounds that are used for medical or non-medical purposes. The objective of the study was to assess the role of biomarkers like total antioxidant capacity (TAC), malondialdehyde (MDA), and troponin I (cTnI) in predicting morbidity and mortality of cases with acute cardiotoxicity arriving at the Menoufia poison control center. Methods: A cross sectional hospital-based comparative study included acutely poisoned cases with cardiotoxic substances (80 participants) who arrived at Menoufia Poison Control Centre (MPCC) over six months and a control group of 80 healthy individuals. Sociodemographic and intoxication characters were registered and a full clinical systemic examination was done. Blood samples were collected on admission to measure (MDA), (TAC), and (cTnI). Results: The mean age of the cases was 25.67±10.57 years and they were mostly females (72.5%), students (48.7%), and from rural areas (61.25%). 45.0% were intoxicated by phosphides. Theophylline was the most common cardiotoxic drug (20.0%). Suicide was the most common form of poisoning (78.75%). 68.8% of the cases survived, while the mortality rate was 31.2%. MDA and TAC were both sensitive and accurate in predicting the severity and mortality of cardiotoxic poisoned cases when assessed in the early hours of poisoning. On the other hand, cTn1 showed no significant changes in cases in comparison to the control healthy individuals. Conclusion: MDA and TAC are sensitive and specific biomarkers for predicting morbidity and mortality outcomes in acute cardiotoxic poisoning and were more efficient than cTn1 in the early hours of acute cardiotoxicity assessment.