Purpose <p>This study aimed to identify distinct patterns of pesticide poisoning in Brazil through the cluster analysis of epidemiological data from 2011 to 2019.</p> Methods <p>A cross-sectional analysis of 49,233 confirmed pesticide poisoning cases was conducted using multiple correspondence analysis and hierarchical clustering. Data from the Brazilian Notifiable Diseases Information System were analyzed by region, demographics, and exposure types.</p> Results <p>Three distinct clusters were identified. Cluster 1 was characterized by severe cases, predominantly involving suicide attempts (~90%), required treatment (99.1%) and fatality rates (93.2% of all cases). Exposures were mostly domestic and occurred via ingestion, with a strong prevalence in the Northeast. Cluster 2 consisted mainly of pediatric cases, marked by accidental and acute domestic exposures, and showed minimal representation in the Southeast and South regions. Cluster 3 had a male predominance (80.1%) and was strongly associated with occupational and chronic exposures, involving cutaneous and respiratory routes, and was most prevalent in the Central-West.</p> Conclusion <p>The study reveals significant regional and demographic disparities in pesticide poisoning across Brazil. These findings underscore the urgent need for targeted public health interventions and stricter pesticide regulations to address regional vulnerabilities and mitigate pesticide-related harm.</p>