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To describe the acute and late complications of organophosphate (OP) poisoning.Case series.Medicine Department at Peoples Medical College Hospital, Nawabshah, from June 2008 to December 2009.A total of 300 patients with organophosphate poisoning admitted to the Medical ICU were included. Baseline investigations included blood complete picture, urea, creatinine, arterial blood gas values, and serum cholinesterase levels. Data was retrieved from the files on a structured proforma. Studied variables included gender, mode of exposure, acute (occuring within 4 weeks) and delayed (occuring after 4 weeks onwards) complicationsThere were 50 (16.66%) males and 250 (83.33%) females with ratio of 1:5. Two hundred and forty eight (82.6%) had ingested while 18 (6%) had inhaled the poison. Acute complications included fits in 50 (16.66) bradycardia in 30 (10%) and hyperglycemia in 15 (5%) patients. Delayed complications (after 4 weeks and later) included monoplegia and mild sensory loss of lower limbs in 4 (2.66) and paraplegia and weakness of upper limbs in 2 (0.66%) patients each. A total of 50 patients died due to different complications in acute period making a mortality rate of 16.66%.Frequency of acute organophosphate (OP) poisoning complications is much higher and related with high mortality and morbidity and where as late complications are less frequent and less life threatening.