This review attempts to reiterate the problem of organophosphate intoxication and the pathophysiologic problems created by these compounds. A discussion of management is included. The case reported of a two-year old child serves to illustrate the tremendously high doses of atropine which may be required to block the acetylcholine accumulated at cholinergic synapses as a result of phosphorylation of acetylcholinesterase by organophosphorus compounds.