Information on the patterns of acute poisoning in Kenyan hospitals is limited, and yet such information is crucial for the appropriate management of poisoning. This study attempted to address this knowledge gap by examining admissions in a regional hospital in Kenya. Method: This was a retrospective review of the hospital records of 96 acute poisoning patients in Rift Valley Provincial General Hospital, Nakuru, in the first six months of 2012. A pretested data collection form was used to obtain data on important variables. Results: The prevalence of acute poisoning was 0.07% (96 of 141 769 cases). The average age of the patients was 22.6 years ± 11.20 years, the majority of whom were males [odds ratio (OR) 2.06]. The most prevalent toxic agent was pesticide (50, 52.08%). The majority of cases were intentional poisoning (48.96%) versus unintentional poisoning (43.75%), and involved mainly males (OR 3.06). Conversely, females were the majority with respect to accidental poisoning (25%) versus males (17.7%). However, accidental poisoning was most prevalent in patients aged 12 years and younger (23, 23.96%). Overall, acute poisoning was most prevalent in the age category of 20-30 years (40, 41.66%), in which intentional poisoning was predominant (26, 27.08%). The majority of cases of acute poisoning were incorrectly diagnosed (OR 1.79). The three patients who died were males (3.13%). Conclusion: This study showed that the majority of acute poisoning cases affected males and were intentional. The study also showed that the most prevalent acute toxic agent was pesticide and that acute toxic agents were often misclassified and hence misdiagnosed. These observations should be included when designing focused hospital poison management protocols.