Introduction: Poisoning with Organophosphate compounds is very common in rural and tribal areas of India. Cardiac toxicity is one of the important manifestations of acute organophosphate poisoning. We in the current study tried to evaluate the ECG manifestations in patients diagnosed with acute organophosphate poisoning reporting to our Institute. Methods: This cross-sectional study was conducted on n=80 adult patients with a history of organophosphate poisoning. All the investigations were performed before initiation treatment the included investigations were estimation of pseudocholinesterase levels, serum electrolytes, and Standard 12 lead ECG. The ECG was recorded before the administration of atropine for treatment. The analysis of ECG was done to determine the rate, rhythm, QRS axis, ST-T changes, measurement of PR intervals, conduction defects if any, measurement of QT interval in all leads, and the longest QT was used for calculation of rate corrected QT or QTc. Results: A total of n=66 males and n=14 females were included in the study. Sinus tachycardia was in n=15(18.75%) cases and sinus bradycardia was in n=12(15%) of cases. The rhythm abnormalities (arrhythmia) were found in n=2 cases and normal sinus rhythm was in n=78 cases. Conduction defects in form of increased PR interval were found in n =3 males and STT changes were recorded among them QTc prolongation was observed in n=21(26.25%) cases. A total of n=10(12.5%) cases expired during the study out of which n=7 cases expired cases had prolonged QTc. Conclusion: Cardiac complications are more frequently associated with the severity of organophosphate poisoning. Monitoring of ECG changes will be useful in the assessment of prognosis. Patients with prolongation of QTc should be intensively monitored chances of ventricular tachycardia, ventricular fibrillation and mortality are highest among these cases.