Organophosphorus (OP) poisoning remains an important cause of morbidity and mortality in developing countries. Cardiac complications often accompany poisoning with these compounds, which are potentially preventable if they are recognized early and treated adequately. This study aimed to assess the potential benefit of plasma N-terminal pro brain natriuretic peptides (NT-proBNP) as an early marker of cardio toxicity induced by acute OP poisoning and to compare its beneficial value with the well-assessed cardiac markers serum "creatine kinase-MB (CK-MB) and cardiac Troponin I (cTnI)". This study was conducted on 150 individuals of both sexes. Participants were divided into three groups: Group I (control), group II (OP poisoning cases without cardiac signs) and group III (OP poisoning cases with cardiac signs). Serum levels of pseudocholinesterase (PCE), CK-MB, cTnI and plasma levels of NT-pro BNP were determined on admission. There were significant differences in plasma NT-proBNP levels between control group versus OP poisoned groups (II and III) and between groups II versus III with no significant differences regarding serum levels of CK-MB and cTnI. It can be concluded that plasma NT-proBNP can be used as an early marker and a diagnostic screening tool for silent myocardial stress that may occur early during the acute course of OP poisoning.