Background: Many people are poisoned by carbon monoxide (CO) each year, either intentionally (e.g. suicide attempts) or by accident. In the prehospital care the early diagnosis is primary for a correct treatment with high flow of oxygen and for the appropriate hospitalization of the patient. The aim of this study is to detect the main factors associated with CO poisoning in our area and to evaluate the role of CO detector in the prehospital setting., Methods: From 1 January 2012 to 1 May 2013, all cases of carbon monoxide poisoning, recorded by the Emergency Medical Service (118) in the Province of Cuneo, were analyzed., Results: Seventy clinical cases were collected, 68.5% of poisonings occurred in the months of December, January and February. Boilers were found to be the main source of indoor CO poisoning (average CO concentration of 66.78 versus 32.92 ppm generated by other heating systems, p = 0.004). CO detector was used in 77.4% of cases. The prehospital diagnosis was properly made in 96% (48/50) of cases in which CO detector was used, versus 70% (14/20) of correct clinical assessment without its use (p = 0.005)., Conclusions: The CO detector is not only a personal protective equipment for Emergency Medical Service operators, but it contributes significantly to increase prehospital diagnosis of CO poisoning, thus suggesting its use in all emergency services in the national territory.