Organophosphorous compounds, the anticholinesterases, produce significant 
morbidity and mortality in India. Although exact estimates are not available, 
hospital based statistics suggest that nearly half of the admissions to 
emergency with acute poisoning are due to organophosphates. Following accidental 
or suicidal exposure, these anticholinesterases lead to three well defined 
neurological syndromes i.e. initial life threatening acute cholinergic crisis 
which often requires management in intensive care unit, intermediate syndrome in 
which cranial nerve palsies, proximal muscle weakness and respiratory muscle 
weakness are common and patients often require respiratory support and delayed 
organophosphate induced polyneuropathy. In addition to these three classical 
neurological syndromes following acute exposure and in some following low dose 
chronic exposure, several neurobehavioural changes have been observed and these 
have been termed together as 'chronic organophosphate induced neuropsychiatric 
disorders' (COPIND). Organo-phosphate compounds produce significant pesticide 
related illness in developing countries. There is, thus, a need to determine 
exact extent of the problem and to develop appropriate strategies to manage 
these cases with available resources in these countries.