In this paper, we construct a new Lagrangian discrete distribution, named the Lagrangian zero truncated Poisson distribution (LZTPD). It can be presented as a generalization of the zero truncated Poissson distribution (ZTPD) and an alternative to the intervened Poisson distribution (IPD), which was elaborated for modelling both over-dispersed and under-dispersed count datasets. The mathematical aspects of the LZTPD are thoroughly investigated, and its connection to other discrete distributions is crucially observed. Further, we define a finite mixture of LZTPDs and establish its identifiability condition along with some distributional aspects. Statistical work is then performed. The maximum likelihood and method of moment approaches are used to estimate the unknown parameters of the LZTPD. Simulation studies are also undertaken as an assessment of the long-term performance of the estimates. The significance of one additional parameter in the LZTPD is tested using a generalized likelihood ratio test. Moreover, we propose a new count regression model named the Lagrangian zero truncated Poisson regression model (LZTPRM) and its parameters are estimated by the maximum likelihood estimation method. Two real-world datasets are considered to demonstrate the LZTPD’s real-world applicability, and healthcare data are analyzed to demonstrate the LZTPRM’s superiority.