The aim of this study was to assess the characteristics of acute poisoning deaths in the deprived region of Epirus, north-west Greece, as they were recorded among the autopsies performed at the Department of Forensic Medicine and Toxicology, Medical School, University of Ioannina, Greece. A retrospective study of the forensic records and the toxicological data of all autopsies performed over the period 1998-2004 revealed that 46 cases (2.9%) out of the 1582 total autopsies performed were attributed to acute fatal poisoning. The age range was from 16 to 94 years (mean+/-SD=46.20+/-22.13). Substances of abuse were implicated in 22 cases (47.8%), pesticides in 9 cases (19.6%), gases in eight cases (17.4%), corrosives in 4 cases (8.7%), and prescription drugs in 3 cases (6.5%). There were 35 males (76.1%) and 11 females (23.9%) and the age range was 16-94 years (mean+/-SD=39.26+/-19.00) and 16-93 years (mean+/-SD=63.36+/-23.46) for males and females, respectively. Fourteen out of the 46 fatal poisonings were suicide (30.4%), 30 (69.6%) were accident, and 2 were uncertain cases. Pesticides were the most common poisons used for suicide purposes (64.3% of suicides). Drugs of abuse were implicated in the majority of accidental poisoning deaths (73.3%) and were recorded mainly for males (95.5%). The selected cases were classified according to ICD-9 codes.