Introduction: Acute poisoning represents one of the most common medical emergencies in childhood. Poisoning patterns change according to age group, type of exposure and the nature and dose of the poison. This study’s objective is to understand the pattern of childhood poisoning in the poisoning treatment unit, Zagazig University Hospitals and to compare these results with those of other countries. Design: retrospective descriptive study. Setting: Poisoning treatment Unit, Faculty of Medicine, Zagazig University Hospitals during the period from January 2009 to August 2010. Participants: All children 12 years old and below. Results: 304 poisoned children were enrolled in this study. 1.6% of the cases involved children below 1 year old. 81% of the cases were between 1-6 years. Children between 7-12 years composed 17.4% of the cases. In all age groups more male cases (57%) were found as compared to female cases (43%). 32% of the poisoned cases were living in Zagazig city while 68% were living in the suburban. In 90.5% of the cases, the accident happened at home while in 9.5% of cases, the accident occurred outside the home. 99.4% of the cases were accidental. The oral route was involved in 72% of the cases. The presenting symptoms were classic in 70% of the cases. 10.2% of the cases were admitted to the Intensive Care Unit. 3.6% were discharged against medical advice. In 86.2% of the cases, observation with or without supportive measures together with decontamination and antidotal therapy whenever needed were sufficient. Pesticide poisoning constituted 28.6% of the total cases. Petroleum products were implicated in 13.15% of the cases. Cleaning and disinfectant agents were the culprits in 17.1% of the cases. Therapeutic drugs constituted 22.9% of the causes of poisoning. Carbon monoxide poisoning was detected in 1.64% of the cases. Natural poisoning was detected in 7.89% of the cases. Conclusion: Our study showed that a relatively large proportion of the visits to the poisoning treatment unit were done by children between 1 and 6 years and that pesticide especially organophosphorus insecticide were the most incriminated agents. Good supportive care is the cornerstone of management for childhood poisoning. Recommendations: We need to reorganize the data collection and use modern techniques of information technology. Public health authorities can adopt the results as the basis for designing prevention measures for different age groups in the population.