Background and Objective: Acute poisoning is a medical emergency. It is important to know the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. This study aimed to assess the pattern and outcome of acute poisoning cases in a tertiary care hospital in Karnataka. Materials and Methods: This is a retrospective hospital record-based study conducted in a tertiary care hospital attached to a medical institution in Karnataka. The study included 136 cases and data regarding age, sex, time elapsed after intake; circumstances of poisoning, name of the poisonous substance, chemical type, duration of hospitalization, severity and outcome were collected in the prestructured proforma. Results: Incidence was more common among males (75.4%) compared to females (24.3). Most cases of acute poisoning presented among 20- to 29-year age group (31.2%) followed by 12- to 19-year age group (30.2%). A majority of poisoning cases (36.0%) were due to organophosphorus compound (OPC). Total mortality was found to be 15.4%. Mortality rate due to corrosives was significantly high compared with OPC poisoning (χ² = 4.12, P = 0.04). Of the 56 patients of OPC and carbamate poisoning, 13 patients (23.2%) had respiratory arrest and required respiratory support. Time lapse had a significant role on the mortality in cases of acute poisoning (χ² = 10.9, P = 0.01). Conclusion: Poisoning is more common in young males. The overall mortality is substantially high, mainly contributed by self-poisoning with insecticides and corrosives. Early care in a tertiary care center may help to reduce mortality in India.