Background Acute poisoning is a critical medical emergency that poses probable hazards as it leads to significant proportions of morbidity that affect the economy and development. Objective This study reveals features, pattern and outcome of acutely intoxicated cases presented to the Zagazig Poison Control Unit (ZPCU) for predicting and efficient handling of these emergencies. Methods It is a retrospective study including acute poisoning cases presented to ZPCU from January 2022 to December 2022. Patients were categorized into three age-related classes: ≤ 20 years, 21–40 years, and > 40 years. Results ZPCU received 1191 cases during 2022. Patients ≤ 20 years old were predominant (45.3%). Females represented 63%. Intentional (suicidal) toxicity was most prevalent (59%). The majority of cases were in summer (36.4%). Medicinal prescriptions were the commonest cause (44.5%) particularly acetaminophen (11%) then clozapine (5.5%). House-hold chemicals signified 14% of cases chiefly Clorox bleach while rodenticide toxicity was 11%. Cases with aluminum phosphide toxicity signified 8.6 %. The mortality rate was 8.1% and almost death was in the age group (21-40 years) and was induced mainly by aluminum phosphide wheat pill (84.5%). Nearly 19% of patients needed ICU admission. Conclusion Acute intoxication is mainly suicidal. Therapeutic drugs were the commonest followed by household chemicals. Most cases needed hospital admission. Efficient GI decontamination plus supportive treatment had the upper hand in managing these cases. Recommendation Restrictive laws banning drug purchasing without formal prescriptions, and skilled educational plans to raise alertness about toxic compounds. Psychological supportive aids for patients with suicidal attempts.