Introduction: Organophospate (OP) poisoning is associated with an increasing incidental or suicidal deaths , with wide use of pesticides in the developing world. Hence early recognization of cardiac toxicity induced by OP is need of the hour. Aims and objectives: To assess the incremental benefit of plasma N-terminal pro brain natriuretic peptides (NT- proBNP) as an early marker of cardiac toxicity induced by acute OP poisoning and to compare its beneficial value over the well-assessed cardiac marker, CPK MB and cardiac Troponin I (cTnI)”. Material and methods: This study consisted of 50 OP poisoning patients. All patients were subjected to full history regarding amount of OP consumed and through physical examination. Estimation of plasma NT pro BNP and Cardiac marker CPK MB and Troponin (TNI) was done by Immuno Fluorence Technique. Observations and results: Sinus tachycardia was common in OP poisoned patients. Among cardiac markers, CPK MB and Troponin I was not significantly raised (p value 0.047) in OP poisoned patients with cardiac toxicity .However there was marked raised plasma NT -Pro BNP levels in these patients with p value - <0.0001). Conclusion: NT-pro BNP is better cardiac marker than CPK MB and cTnI, for detecting silent early myocardial damage that occurs in OP poisoning patients.