OBJECTIVES: :The present study aimed to identify the most appropriate dosage regimen of pralidoxime that can be recommended for the management of OP poisoning.    METHODS: An open labeled cross-sectional, nonrandomized observational study was carried out in emergency wards of tertiary care hospital. A total of 256 OP poisoned patients were admitted between 2009 to 2013. The basic demographical, clinical characteristics and severity were assessed at admission. Based on the pralidoxime dosage regimen patients were categorized into 4 different groups viz. control, intermittent, 500mg/ hour, 1g/ hour groups. The clinical outcome analyzed in terms of hospitalization days, ventilatory days, total atropine required, and incidence of intermediate syndrome and outcome were assessed for comparison with pralidoxime regimen RESULTS: The results showed that majority of OP poisoned patients were in the age group of 21-30 years, and males predominated the females (2.3:1). Clinical Severity assessment of these patients showed that most of them had moderate to high severity. Outcome analysis showed that patients of continuous infusion of pralidoxime had significantly improved recovery rate with least sequel and fatality rate. The incidence of intermediate syndrome, number of ventilation days, total atropine requirement, number of hospitalization days and mortality rate significantly reduced in continuous infusion group.  CONCLUSIONS: Continuous infusion of pralidoxime at 500 mg/hour  resulted in significantly better clinical outcome than other dosing regimens and not associated with adverse derug reactions