A twenty-one years retrospective study (1980-2000) of acute poisoning deaths carried out at the Department of Forensic Medicine and Toxicology at Government Medical College Hospital, Jammu and Gov't. Medical College Hospital, Chandigarh--the two demographically different zones of Northern India. Union Territory of Chandigarh, which is the capital of Punjab and Haryana states, is one of the most developed parts of India, whereas Jammu primarily represents the rural India. The study is an attempt to analyze the various changing trends in acute poisoning in these zones with the aim that it will help immensely the health policy-makers to equip health care institutions accordingly. The present study reveals a steep increase in the number of acute poisoning cases and a change in the trends of the most commonly used poisons with the passage of time. Males outnumbered females and youth formed the majority of fatalities. The main victims were unemployed youth and students, followed by agricultural and domestic workers. Despite India's predominantly rural character, the urban preponderance of deaths by poisoning may reflect the role of leading a more stressful life in urban areas.