Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide. A five year retrospective study of poisoning cases in seven governorates of Upper Egypt investigated by Assiut Forensic Chemical Laboratory in the period from January 2002 to December 2006 was conducted to investigate the patterns, mode of poisoning, incidences and types of poisons. The total number of cases was 407. The geographical distribution was; 14.0% from Almenia, 44.0% from Assiut, 19.9% from Sohag, 16.5% from Qena, 2.7% from Aswan, 2.2% from Red sea and 0.7% from New Valley. The highest incidence of poisoning was found in 2006 (29%) followed by 2004 (20.4%) then 2002 (18.7) and 2005 (16.2%), lastly 2003 (15.7%). The highest incidence was in males (61.2%) and the maximum number of cases was found between 21 and 30 years (30.2%). Suicide cases represented 49.6% of total cases 59.9% of them were females while cases of abuse represented 32.7% and 95.5% of them were males. Pesticides were the commonest poisons detected (47.3 % of the total), where organophosphates represented (22.1%) and carbamates represented (20.6 %) of the total cases. Also they were the main killer used in suicide cases in addition to hair dye ingestion (18.4%). The use of hair dye for poisoning was common particularly in the south governorates (Qena 81.6% and Aswan 8.2%), either for suicide (83.7%) or trials of suicide (4.1%) also for murder in 10.2% of hair dye poisoning cases. Alcohol is the commonest substance of abuse followed by antipsychotics (60.9% and 20.3% respectively). Cannabis and hydrocarbons had semilar percentages (5%.3) followed by hypnotics, opoides and other drugs. On conclusion; this study revealed that there is annual increase in the number of poisoning cases particularly in young adults. Deliberate self- poisoning is a major problem, followed by drug abuse. Pesticides were the main killer followed by hair dye. Alcohol was the commonest abuse substance. There was male predominance except in suicide cases where females predominate.