Background Acute poisoning is a critical medical emergency that obtain probable hazards as it leads to significant proportions of morbidity that affect economy and development. Objective This study reveals features, pattern and outcome of acutely intoxicated cases presented to 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%). Female represented 63%. Intentional (suicidal) toxicity was most prevalent (59%). Majority of cases was 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 %. Mortality rate was 8.1% and almost death were in age group (21-40 years) and was induced mainly by alumunium phosphide wheat pill (84.5%). Nearly 19% of patients needed ICU admission. Conclusion Acute intoxication is mainly suicidal. Therapeutic drugs were the commonest then house hold chemicals. Most cases needed hospital admission. Efficient GI decontamination plus supportive treatment had the upper hand in managing these cases. Recommendation Restrictive laws banning drugs purchasing without formal prescriptions, skilled educational plans to raise alertness about toxic compounds. Psychological supportive aids for patients with suicidal attempts.