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Background: This paper sought to characterize pediatric clonidine ingestions, report trends in incidence, and evaluate outcomes using the Florida Poison Center's data over a period of 15 years, from 2002 to 2016. Results: There were 3444 total exposures. Forty percent of the cohort was female. The median age was 5 years. The age distribution changed over time to a higher proportion of teenagers exposed (p < 0.0001). From 2002 to 2016, exposures increased from 182 to 378 with a rise in incidence from 4.8 to 9.1 per 100,000 children. Acute on chronic exposures increased from 29.3% to 42.2% (p < 0.0001). Female intentional ingestions increased from 52 to 70% (p < 0.0001). Twenty-four percent were managed at home, 34% were discharged from the emergency department, 8% were admitted to the floor, and 25% were admitted to the intensive care unit (ICU). Major medical outcomes were associated with older age (p = 0.0043, 95% CI 0.0015 to 0.0080) and higher clonidine dose (p < 0.0001, 95% CI 0.0347 to 0.0600). Older children were more likely to ingest a larger dose of clonidine (p < 0.001, 95% CI 0.0531 to 0.0734), while younger children were more likely to be admitted to the ICU (p < 0.001, 95% CI − 0.0092 to − 0.0033). Males were more likely to have acute on chronic ingestions (p < 0.001, 95% CI − 0.1639 to − 0.0982); females were significantly more likely to be admitted to the ICU (p < 0.0001, 95% CI 0.0380 to 0.0969). Conclusions: Our analysis shows an increase in the incidence in pediatric clonidine exposures over time despite adjustment for population growth. [ABSTRACT FROM AUTHOR]