In treating patients with acute organophosphorus pesticides poisoning, clinicians pay more attention to poisoning counterattack, while atropine dependence, which resembles counterattack, is not yet fully recognized. The authors analysed 1,039 patients with this kind of poisoning treated in 7 years. Among these cases 157 were dependent on atropine, consisting of 15.1% of the total. The clinical manifestations of the dependence were described. The diagnostic criteria of the dependence and its differential points from counterattack were suggested. It was found that higher occurrence rate of the dependence was seen in patients of younger age, with more severe poisoning and with longer duration and higher total dose of atropine treatment (P < 0.005 respectively). It is considered that its mechanism might be related to increased number of M-receptor and excessive accumulation of acetylcholine. It is suggested that quantitative analysis of relevant receptor be developed.