Background: The COVID-19 pandemic has triggered worldwide changes which affect humans' daily life, with impression on their health either physical and mental and also, their social and recreational behaviors. Acute poisoning is considered as a noteworthy danger to worldwide public health. Aim of the study: The study aimed to determine the pattern of poisoned patients before, during and after COVID-19 pandemic at Poison Control Centre-Zagazig University Hospitals (PCC-ZUH). Methods: A retrospective observational study, hospital-based, was conveyed using medical records and electronic databases of acutely poisoned patients attended to PCC-ZUH in the period from January 2019 to December 2021. Results: over three years, the PCC-ZUH managed to service large number of patients peaking to 2457 patients were hospitalized in 2021. Most admission were aged 15-25 years old represent 34.67% in 2021. Female represented 55.1% in 2019 and rising to 68% in 2020 and decline to 66% in 2021. Drug- poisoning accounted for 55.23% in 2019, 50.24% in 2020 and rising to 54.82% in 2021. Non-drug poisoning was increased from 44.77% in 2019 to 49.76% in 2020 then decline to 45.18% in 2021. Improvement was the prevalent outcome with increase demand of using toxicological measures in 2021. Conclusion and recommendation: The COVID-19 pandemic change pattern of poisoning cases. The lockdown status played a role in increase the suicide incidence. Urgent response from healthcare providers, policymakers and mental health support are needed especially for vulnerable age group and female.