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Abstract Background Zinc phosphide (ZnP) is a dark gray crystalline compound used as a rodenticide against rodents such as mice. ZnP poisoning may be accidental or suicidal. The aim of this study was to investigate the clinical manifestations and treatment management of hospitalized patients with ZnP poisoning in Mazandaran Province, northern Iran. Methods Between 2013 and 2017, a cross-sectional study was performed on hospitalized patients with ZnP poisoning who were referred to two training hospitals in Mazandaran Province, northern Iran. Results A total of 127 patients participated in this trial, including 71 (55.9%) men and 56 (44.1%) women. The patients’ average (standard deviation) age was 25.5 (±16.82) years, and it took 2.18 (±2.23) hours to refer them to the hospital. There were 42 (33%) cases with less than one package, 9 (7%) cases with several packages, and 76 (60%) cases with no particular usage. Conclusions This study has shown that ZnP poisoning may be asymptomatic initially or with mild clinical symptoms that may gradually worsen. Therefore, hospitalization and obtaining a history and a careful physical examination should be considered.