OBJECTIVES: To compare trends in emergency room visits versus hospitalizations due to unintentional poisonings in Kansas City, Missouri, from 2001 to 2008. METHODS: We conducted a retrospective study using Missouri Hospital Discharge Data for Kansas City, Missouri.  The data included the causes of emergency room visits and hospitalizations, sex, race, age and zip code.  The zip code data were used to categorize the patient’s zip code level median family income and to assign the individual to the appropriate local Health Zone.  Unintentional poisonings were identified by ICD-9 E-code 850.0 to 869.9.  Chi-square tests were used to compare rates of emergency room visits or hospitalizations for each demographic variable.  Multiple logistic regression analyses were conducted. RESULTS: Unintentional poisonings accounted for 0.4% of the 1,370,453 emergency room visits from all causes and 0.5% of the 496,502 hospitalizations from all causes.  Males had the highest rates for both emergency room visits and hospitalizations due to unintentional poisonings.  Utilization by age, race, and median family income exhibited opposite trends for emergency room visits and hospitalizations.  Persons utilizing emergency departments were more likely to be younger, white, and reside in higher median family income zip codes, whereas hospitalized patients were more likely to be older, black, and reside in lower median family income zip codes.  These differences were reflected in the patient’s Health Zone of residence. CONCLUSIONS: Except sex, trends of emergency room visits and hospitalizations due to unintentional poisonings, were opposite across other demographic variables.