Background: Organophosphate compounds are the commonly used pesticides in our country. These compounds are highly toxic. Organophosphorous poisoning is therefore associated with high mortality and morbidity. Early diagnosis and treatment is the key in the management of these cases. We report our experience with the intensive care management of serious OP insecticide poisonings. Materials and Methods: An observational study was made in 60 patients who were admitted with OP poisoning. They are treated with atropine and pralidoxime (PAM). Ventilatory and circulatory support was provided, if required. Conclusion: Results showed that majority of cases were due to suicidal attempt and outcome improved with early intervention. However, mortality still remains high due to lack of proper guidelines in the management of such cases and probably, the limited resources in hospitals in terms of trained doctors, nurses, support personnel, laboratory facilities and finance, may be partially responsible for the high number of deaths.