All rights reserved. Abstract Acute poisoning by cholinesterase enzyme inhibitors insecticide continues to be a detrimental problem and a potential cause of mortality especially in developing countries. Early intervention in such cases is proven to be helpful. The aim of the present work was to assess the role of serum β-glucuronidase level as probable marker for the assessment of acute cholinesterase enzyme inhibitors insecticides poisoning. Subjects and methods: the study included 60 cases of

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... acute poisoning by cholinesterase enzyme inhibitors insecticides, admitted to the Poison unit of Alexandria Main University Hospital, another 15 healthy volunteers were included as control group. All the cases were subjected to: thorough history taking, full clinical examination, grading of poisoning severity score (PSS), laboratory investigations (serum cholinesterase activity level (CHE) and serum β-glucuronidase level (βG). Results: Serum CHE levels were significantly decreased, while Serum βG were significantly increased in the patients compared with the controls, and also, with increasing severity of poisoning. A significant negative correlation was detected between level of serum CHE and duration of hospitalization, while a significant positive correlation was found between serum level of βG and length of hospital stay. In addition, a significant inverse correlation was found between levels of CHE and βG whether in control group or in cases. Data obtained from ROC curve analysis revealed that serum βGlevel was more helpful in diagnosis of OP poisoning than CHE (accuracy 100% versus 80%), while both serum CHE andβG levels were of equal accuracy percentage for detection of poisoning severity and for prediction of outcome (100% and 91.67% each). Conclusion: SerumβG could be used as a good biomarker for the diagnosis and prognosis of cholinesterase enzyme inhibitors insecticide poisoning.