Background: Rodenticide is one of the pesticides and heterogeneous substances used to kill rats. Rodenticide poisoning is the major health problem in Asian countries, particularly mode of self-poisoning, prevalent in India. It causes hepatotoxicity and no antidote has been found. N-acetylcysteine (NAC) is a powerful antioxidant and used in the treatment of acetaminophen-induced hepatotoxicity.  The aim of the study is to find the outcome of use of NAC in rodenticide poisoning.  The main objectives of this study were to determine the role of NAC in liver impairment rodenticide poisoning patients.   Methods: A record based observational study was conducted for the period of 3 months from August 2019 to October 2019 at Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu. Data were collected according to the proforma designed and results were analyzed using standard methods.Results: Out of 50 patients, 21 (42%) were males and 29 (58%) were females. Age group between 21-30 years contributes the highest 20 (40%). Majority of type of rodenticide compound consumed by patients were paste 29 (58%) and less than four hours 34 (68%) patients were admitted. Patients with abnormal liver functions were tested, serum glutamic oxaloacetic transaminase/ aspartate aminotransferase -12 patients, 7 treated with NAC. serum glutamic pyruvic transaminase/ alanine aminotransferase - 9 patients, 2 treated with NAC. 37 (74%) were recovered out of 50 (100%), among them 28 (56%) treated with NAC.Conclusions: In liver impairment rodenticide poisoning patients, early use of NAC shows a significant result and the rate of recovery is also high.