Introduction: Organophosphate (OP) poisoning is a well recognized phenomenon in the farming community with many documented complications. However, deliberate ingestion of organophosphates in paediatric population is almost unheard of. This is a case of OP poisoning in a child leading to cardiac complications. Case presentation: A 12 year old boy was brought to the emergency unit by parents due to abnormal behavior and foul smelling vomiting. On admission the patient confessed to having ingested 15ml of OP containing insecticide one hour ago, with suicidal intention. He had profuse sweating, vomiting, excessive salivation, and dizziness, although consciousness was preserved. Examination revealed a heart rate of 40bpm and pin-point pupils. Gastric lavage was done and activated charcoal administered. He was started on atropine infusion under close monitoring. Over the next two hours, his heart rate increased, but ECG showed a new right bundle branch block. Cholinergic symptoms were reversed after 6 hours but ECG changes persisted. After atropinisation, the patient was monitored with serial ECGs, which showed complete resolution of the bundle branch block within the next 24 hours. He did not have any residual symptoms, and was free of intermediate syndrome. Following -8mental health evaluation and counseling, he was discharged with no further complications. Follow up was arranged in paediatric and psychiatry clinic. Conclusion: This case demonstrates rare possibility of life threatening presentations and complications of acute poisoning in the paediatric population. High index of clinical suspicion, early recognition and prompt management are essential for a positive outcome.