Introduction: Due to introduction of new forms of agriculture and transformation of the treatment and preventive service in recent years, there has been a false impression of a sharp decrease in the level of occupational morbidity among agricultural workers 30 % to 25 % in the structure of general occupational morbidity in the 80–90s down to 0.2-0.4 %. The aim: Summarize data on the prevalence, causes, structure of acute pesticide poisoning in agricultural workers at the current stages of its reform in order to improve preventive measures. Materials and methods: Data on the prevalence, causes and structure of 647 cases of acute pesticide poisoning in agricultural workers over the past 25 years have been summarized; staff of the Scientific Toxicology Center took part in the sanitary-hygienic investigation and establishment of the diagnosis. Results: The causes for the development, aetiology and structure of 647 cases of acute pesticide poisoning, among which 522 cases of acute poisoning of field beet growers with 2,4-D-based herbicides (80.7 %), 60 cases (9.3 %) of OPC poisoning, 36 cases of beet growers poisoning with sulphonylurea-based herbicides, 14 patients with acute synthetic pyrethroid poisoning, and isolated cases (15 patients) of intoxication with aluminium phosphide, dithiocarbamates, Vitavax, and Fipronil were analysed. Conclusions: Analysis of the causes of the development and structure of poisoning has allowed to optimize the complex of preventive measures to strengthen sanitary control over the implementation of individual and public safety hygienic regulations during storage and use of pesticides.