Organophosphorus compound poisoning is one of the most common poisoning in rural areas. The main symptoms of Organophosphorus compound poisoning is due to stimulation of nicotinic and muscuranic receptors. The cholinergic symptoms and prognosis is assesed by acetylcholinesterase levels which is not readily available in all clinical laboraties. So a cheaper and easily quantifiable serum markers like creatine kinase and liver enzymes can be used in predicting as well as assesing the prognosis with organophosphorus compound poisoning. A prospective study was done in about 110 patients with consumption of organophosphorus compound poisoning admitted in the department of medicine, Chengalpattu medical college and hospital. Patients with history of chronic liver disease and myopathy were excluded. Patients were classified according to peradeniya organophosphorus poisoning scale. The present study found that the initial serum CPK level is comparable for BChE level and can be used as an alternative biomarker in diagnosis of acute Organophosphorus compound poisoning, provided that exclusion of any other diseases or conditions that may cause rise in CPK levels, these results were statistically significant (p < 0.05).