A prospective observational study of 12 months duration was conducted in a teaching hospital on 278 cases of acute poisoning reported to emergency department from October 2018 to October 2019. Data regarding patient demographics, type of poisoning agent, duration of hospital stay and outcome were collected and analyzed. The common poisoning agents ingested were organophosphate compounds (41%), drug overdose (36%), Rodenticide (9%), House cleaning agents (6%), Mosquito repellents (4%), Corrosives (1%) and Kerosene (1%). Common drug overdose leading to poisonings were sedatives (9%), followed by nonsteroidal anti-inflammatory agents (4%). Of the 278 patients, 87 (31%) were males below 30 years of age. A major number of the patients worked as labourers (27%) and farmers (17%) and most were illiterate (36%). Suicide (79%) was found to be the major reason for poisoning. Acute poisoning is a major public health issue, especially among younger population and less educated. Analyzing the trends in poisoning in south India periodically will assist the healthcare workers and policy makers to device suitable management and effective prevention strategies like educational interventions about insecticide handling and establishing poison information centres.