OBJECTIVE: To determine the serum pseudocholinesterase level as a diagnostic tool in patients with suspected organophosphorus poisoning (OP). PATIENTS AND METHODS: Twenty five patients of suspected organophosphorus compound of age ≥18 years, either gender were randomly selected while excluding the patients who had taken other compound as poisoning substance and patients with prior hepatic and renal dysfunction. The detail clinical history was taken and specific clinical examination was

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... . The serum level of enzyme pseudocholinesterase was estimated on daily basis for three days while the data was compiled and manipulate in SPSS 17. RESULTS: Out of 25, eighteen (72%) were males and seven (28%) were females having mean ± SD for age was 32.98±8.95. Most of the patients were admitted within 6 hours of intoxication. Eight (32%) patients has mild, seven (28%) has moderate and ten (40%) has severe OP poisoning. The common features identified were nausea and vomiting 18 (72%), diarrhea and abdominal cramps 15 (60%), miosis 12 (48%) and difficulty in breathing 14(56%). The patients who survived and improved had gradual raising values of enzyme levels and the patients who died did not show subsequent increase in enzyme level. CONCLUSION: Serum pseudocholinesterase activity is the reliable and best tool during early stages of poisoning with value above 4200 U/L has the indication of survival and subsequent increase in level also the indicator of best prognosis while the low enzymatic level during early stage of poisoning revealed increased mortality. KEYWORDS: Pseudocholinesterase, enzyme, organophosphorus