We report a case of organophosphate poisoning presenting as a cardiac arrest. The diagnosis was delayed due to the absence of a history of insecticide ingestion and the unusually acute presentation. Cardiac arrest with bradycardia poorly responsive to adrenaline and responsive to high dose atropine should alert the clinician to the possibility of an anticholinesterase poisoning. Early diagnosis is essential in order to manage these patients appropriately and increase the probability of survival.