<p>Brazil’s dependence on agribusiness has driven investments to increase productivity, resulting in intensified pesticide use and raising public health concerns. This study analyzed compulsory reports of exogenous pesticide intoxication in major agricultural states between 2012 and 2022 to characterize epidemiological patterns and surveillance practices. The research comprised a literature review and a descriptive analysis of pesticide use and health impacts; a documentary review of legislation on epidemiological surveillance, highlighting the Notifiable Diseases Information System (SINAN) and TabNet as monitoring tools; and quantitative data collection from 11 Brazilian states (Pará, Rondônia, Rio Grande do Sul, Paraná, Mato Grosso, Mato Grosso do Sul, Goiás, São Paulo, Minas Gerais, Rio Grande do Norte, and Bahia). General information was also compiled on the most widely used pesticide groups in Brazil, including herbicides (e.g., glyphosate, 2,4-D), insecticides (e.g., organophosphates, pyrethroids), and fungicides (e.g., triazoles), noting exposure pathways, toxic doses, and available antidotes for acute intoxication. Results indicated substantial underreporting of cases, even in states with the highest pesticide sales. Most cases involved men with low educational attainment, exposed mainly through accidental or occupational circumstances. These findings highlight the urgent need to strengthen epidemiological surveillance and preventive actions to mitigate adverse health effects of pesticide exposure in Brazil.</p> Graphical abstract <p></p>