In Bangladesh all poisoning death cases are recorded as unnatural death and medico-legal autopsy is routine. This paper investigates the pattern, trend and incidence of unnatural poisoning deaths attended in Sir Salimullah Medical College Mortuary, Dhaka, Bangladesh from January 1, 1988 to December 31, 1997. A total of 2534 medico-legal autopsy cases were carried out during this period and 273 deaths by poisoning constituted 10.8%. The autopsies done were predominantly male (54.6%). The 13-24-year-old age group was the highest victim group (48.4%). The urban incidence was 60.8%. The main reasons behind taking poison were diseases, familial dispute, alleged insanity and marital discord. Organo-chlorine compounds were the main killer (51.6%) followed by organo-phosphorous compounds (37.7%). This study shows that poison death victims are gradually increasing, in terms of growth rate male death is higher than female, and maximum number of deaths occur below 24 years of age. The trend of poisoning with organo-chloride compounds is being replaced by organo-phosphorous compound use.