Background: Aluminium phosphide (AlP) is a pesticide used to preserve grains from rodents and household bugs. It’s one of the most common causes of poisoning in developing countries as it's cheap, easy to use, and instantly fatal. Aim of the study: Assessment of the magnitude of acute AlP poisoning, characters of prevalent cases, and the general outcome of poisoning in the Eastern Delta of Egypt over the last five years. Patient and Method: We surveyed all patient records of AlP-poisoned cases admitted to local poisoning centers; Poison Control Center-Zagazig University Hospitals (PCCZUH) and Zagazig General Hospital, from Jan. 2017 to Jan. 2022, we calculated poisoning incidence over the studied years and extracted patient demographic data and poisoning sequelae to create detailed statistical patterns, then we evaluated all available case data to relate them to the patient outcome. Results: AlP poisoning is an increasing public health problem with the most frequent age group being 18 to 45 years (66%). Females represented the majority (62.5%), and 79.3% of the cases were from rural areas. Most of the cases were suicidal (70.6%), and the overall mortality rate of AIP over the last 5 years was 72.5%. Conclusions and Recommendations: The rising incidence of AlP poisoning is a threatening public health problem that mandates the government intervention to enact restrictive legislation on the purchase and use of wheat pills and raise public awareness through community education programs or campaigns