Background: Acute aluminum phosphide (ALP) poisoning has become a major suicidal crisis in developing countries due to increasing mortality rate and absence of specific antidote. Aim: This study aimed to evaluate the value of APACHE II and SOFA scores in predicting outcomes in patients with acute ALP poisoning and construct a predictive model for ALP poisoning. Patients and methods: This cross sectional study included patients with history of acute ALP poisoning admitted to the Poison Control Center of Ain Shams University Hospitals (PCC-ASUH) from the beginning of August 2022 to the end of April 2023. For each patient, the demographic, intoxication and clinical data were recorded. Investigations done on admission included blood gases, serum sodium, potassium, liver enzymes, creatinine, complete blood count, and electrocardiogram (ECG). Results: This study included 110 patients of both sex with acute ALP poisoning. Multivariate regression analysis revealed that six factors were the most predictive factors of mortality and they were valid to construct the new predictive score at cut off value of MAP <70 mmHg, GCS ≤12, PH ≤ 7.28, HCO3 ≤ 12.6 mEq/L, PO2 < 90% mmHg and abnormal ECG. A new predictive ALP scoring system was then constructed of six parameters each taking a constant logistic score to give a total score of 33. Conclusion: The current study constructed a new predictive score that could be useful at the emergency department for early prediction of severity among patients with ALP toxicity based on simple, reliable, and easily obtainable parameters that are done routinely for every patient.