Background: Hydrocarbons are widespread, potentially dangerous substances present in fuels and household products. Toxic exposure to such compounds poses significant health consequences. Aim of the work: studying pattern and outcome of acute hydrocarbon poisoning in patients admitted to Alexandria Poison Center (APC), Egypt. Patients and methods: Study included 178 acute hydrocarbon-intoxicated patients admitted to APC from first of January till end of June 2022. Patients were subjected to detailed history taking, clinical examination, and management. Results: Males constituted 64.6% of cases, with more than half of exposures in age group ≤ 3 years. Kerosene stood behind half of cases. Poisoning was accidental in 97.8% of patients. Ingestion occurred in all patients, combined with other routes in 7.9% of cases. 92.2% of patients were symptomatic, with 39.9% having irritant manifestations. Laboratory analysis showed leukocytosis (30%), metabolic acidosis (24.7%), and hypoxia (7.9%). Radiological abnormalities were recorded in 37.6% of patients, mainly increased broncho-vascular markings (BVM) (15.7%). Hydrocarbon-induced sequelae occurred in 33.1% where pneumonitis was the most common (29.7%). All patients received supportive treatment. 41.1% needed antipyretics. 3.4% of cases were admitted to ICU. 92.1% of the cases completely recovered, 6.8% were discharged against medical advice, and 1.1% of cases died. Conclusion: Hydrocarbon toxic exposure commonly occurs especially in pediatrics by accidental ingestion mainly of kerosene. Fever was frequently present, and pneumonitis was the most common hydrocarbon sequelae. Increased BVM was the most common radiological finding yet may not be associated with any sequelae. Hydrocarbon poisoning is usually associated with benign outcomes if managed adequately.